Comprehensive Outpatient Care in Rheumatoid Arthritis

Katz, Sidney; Vignos, Paul J.; Moskowitz, Roland W.; Thompson, Helen; Svec, Kathryn H.

doi:10.1001/jama.1968.03150060023004

Cited by 71 publications

(6 citation statements)

References 10 publications

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“…Only two consisted exclusively of home visiting nursing [8,9], and one of these almost completely focused on informal caregivers rather than directly on patients [9]. The other 11 interventions included components in addition to home visiting nursing, namely, formal multidisciplinary conferences [10-14], social worker case management [12,15], collaboration with geriatricians [11,14,16], a community geriatric evaluation unit [11], community-based long term care [17], a health center provider team [18], reablement home care staff, home care managers, occupational therapists, and other categories of healthcare professionals [19], and a multi-component restorative program that is also separately delivered by a physiotherapist or an occupational therapist [20]. …”

Section: Introductionmentioning

confidence: 99%

“…Rather, these studies present information on the Katz ADL Index [8,10,15], Barthel-formatted ADL items comprising scales with ranges of 0–20 [14] and 0–100 [9,18], an ADL scale ranging from 9 to 29 based on modified Barthel items [20], ADL scales with ranges of 0–100 [16], 0–6 [11], 0–20 [17], 5–15 [12], and 0–12 (OASIS-B items) [13], and the proportion of subjects dependent in at least one ADL [16]. The one exception [19] included 11 ADLs for which both a total mean and individual item data are presented.…”

Section: Introductionmentioning

confidence: 99%

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Effects of a home visiting nurse intervention versus care as usual on individual activities of daily living: a secondary analysis of a randomized controlled trial

Friedman

Liebel

et al. 2014

BMC Geriatr

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BackgroundHome visiting nurses (HVNs) have long been part of home and community-based care interventions designed to meet the needs of functionally declining older adults. However, only one of the studies including HVNs that have demonstrated successful impacts on Activities of Daily Living (ADL) has reported how those interventions affected individual ADLs such as bathing, instead reporting the effect on means of various ADL indices and scales. Reporting impacts on means is insufficient since the same mean can consist of many different combinations of individual ADL impairments. The purpose of our study was to identify which individual ADLs were affected by a specific HVN intervention.MethodsThis is a secondary analysis comparing two arms of a randomized controlled study that enrolled Medicare patients (mean age = 76.8 years; 70% female) with considerable ADL impairment. At baseline difficulty with individual ADLs ranged from a low of 16.0% with eating to a high of 78.0% with walking. Through monthly home visits, the HVN focused on empowering patients and using behavior change approaches to facilitate chronic disease self-management. Three categories of analyses were used to compare difficulty with and dependence in 6 individual ADLs between the HVN (n = 237) and care as usual (n = 262) groups (total N = 499) at 22 months after study entry: (1) unadjusted analyses that strictly depend on random assignment, (2) multinomial logistic regression analyses adjusting for baseline risk factors, and (3) multinomial regression analyses that include variables reporting post-randomization healthcare use as well as the baseline risk factors.ResultsCompared to care as usual, patients receiving the HVN intervention had less difficulty performing bathing at 22 months. However, there were no effects for difficulty performing the other 5 ADLs. While no effects were found for lower levels of dependence for any ADLs, impacts were detected for the most dependent levels of 4 ADLs: patients experienced less dependence in walking and transferring, a substitution effect for toileting, and more dependence in eating.ConclusionsFuture research is needed to confirm these findings and determine how HVN interventions affect individual ADLs of older adults with multiple ADLs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of a home visiting nurse intervention versus care as usual on individual activities of daily living: a secondary analysis of a randomized controlled trial

Friedman

Liebel

et al. 2014

BMC Geriatr

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“…Seeing a range of people, patients can obtain different views about their disease and its treatments and thus, some believe, adequate education. For others, however, it is not enough, and education programmes comprising lectures,3-6 or metrology/physiotherapy cinics, [7][8][9][10][11] or group counselling sessions2 13 have been established. Evaluating these programmes has always proved difficult, and they have produced some conflicting results.…”

mentioning

confidence: 99%

Patient education and the consultation: the importance of lay beliefs.

Donovan¹

1991

Annals of the Rheumatic Diseases

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“…Previous studies evaluating systems of care for arthritis patients already in the health care system suggest that short-term objective outcomes are improved by a multidisciplinary team (6,7). To our knowledge, this pilot program is the first attempt to develop and evaluate a community intervention program for persons with arthritis.…”

mentioning

confidence: 98%

Evaluation of a Pilot Program for Rheumatic Disability in an Urban Community

Liang

Phillips

Scamman

et al. 1981

Arthritis & Rheumatism

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A program for the systematic detection and management of arthritis disability was developed for an urban population. A survey identified 601 persons with rheumatic disability in a population of 9,500-10,550. Seventy-eight persons were evaluated and given recommendations. An ombudsman assisted the clients in obtaining health services and coordinated care. An evaluation 6-8 months later showed increased utilization of and referrals to relevant services but, on the whole, tittle improvement in functional capacity was noted. However, the small numbers do not permit more definite conclusions.The present health system does not adequately address the unique clinical features of chronic arthritis. The general physician encounters the majority of per-

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Comprehensive Outpatient Care in Rheumatoid Arthritis

Cited by 71 publications

References 10 publications

Effects of a home visiting nurse intervention versus care as usual on individual activities of daily living: a secondary analysis of a randomized controlled trial

Effects of a home visiting nurse intervention versus care as usual on individual activities of daily living: a secondary analysis of a randomized controlled trial

Patient education and the consultation: the importance of lay beliefs.

Evaluation of a Pilot Program for Rheumatic Disability in an Urban Community

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