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

Liang, Matthew H.; Phillips, Elizabeth; Scamman, Mary; Lurye, C. S.; Keith, Allan; Cohen, Louise Glassner; Taylor, George A.

doi:10.1002/art.1780240712

Cited by 12 publications

(1 citation statement)

References 12 publications

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“…Data from the 1979 Health Interview Survey [25] indicate that only 40% of arthritis patients were currently under treatment or medication recommended by a physician. A community study by Liang et al [26] indicated that 30% of persons with arthritis-related functional problems were under no care for them, even though many identified regular physicians. Yelin and Epstein [27] showed that even in areas with significant musculoskeletal disability, community physicians may feel no need for rheumatologists.…”

Section: Fertile Research Areasmentioning

confidence: 98%

Patient education in the rheumatic diseases: A research agenda

Daltroy

Liang

1988

Arthritis & Rheumatism

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Despite the explosion of research in patient education and compliance, little has been specific to rheumatology until the last few years. Many effective educational techniques can be borrowed from research on other chronic diseases. Research should be theory based, but it should also emphasize the testing of various combinations of intervention strategies. Fertile research areas include access to care, patient-provider interaction, adherence to medical regimens, and diffusion of practical educationul skills among caregivers. Common limitations in research methodology ure identified and addressed in this paper. This paper recommends priorities for research in patient education for the rheumatic diseases. These recommendations are based on the fact that delivery of effective education to patients calls for research to increase our technological base, i.e., improved methods for arthritis patient education and for diffusion of these methods to practitioners. The recommendations are based on a selective review of the literature on patient education and compliance, a field that has made rapid growth and progress in the past 20 years,

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Section: Fertile Research Areasmentioning

confidence: 98%

Patient education in the rheumatic diseases: A research agenda

Daltroy

Liang

1988

Arthritis & Rheumatism

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Evaluation of comprehensive rehabilitation services for elderly homebound patients with arthritis and orthopedic disability

Liang

Partridge

Larson

et al. 1984

Arthritis & Rheumatism

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Fifty-seven elderly homebound patients with arthritis and orthopedic disabilities were randomized to a goal-oriented outreach rehabilitation program or to usual treatment. Although 64% of patient goals were met, there were no overall significant differences in functional scores, institutionalization, or contentment between treatment and control periods. Twenty-three patients had maintained clinical improvement at the end of the study and some patients were dramatically improved with simple measures. The program's marginal costs were modest and consisted primarily of expenses associated with therapist's visits. The total costs of assistive devices and home modifications amounted to $1,902. Twenty-five percent of the homebound population could benefit from such services but the actual number who would partake is small.A million people in the United States are homebound and studies of these individuals indicate that musculoskeletal disorders and arthritis are the most common causes of being homebound (1,2). A previous study from our center suggested that many individuals with musculoskeletal disorders affecting function could have benefited from simple rehabilitation measures to improve or maintain function (3). Among the homebound, 80% receive help from their immediate families and friends and 15% receive care from a nurse, home health aide, or paid homemaker (4). Physical and occupational therapy services in our community are limited by rules of third-party reimbursement. Rehabilitation services focus on acute conditions whereas chronic or slowly deteriorating disorders receive less attention.In 1980 we organized a study with two objectives:1. To evaluate, in a randomized controlled trial, the effects of stepped-up rehabilitation versus usual rehabilitation for improving and maintaining function of homebound patients with arthritis and musculoskeletal disorders; 2. To document the rehabilitation needs of homebound arthritis patients as they might be met by the current state of the art. DESCRIPTION OF SAMPLERecruitment. Patients receiving home care from four licensed home care programs serving Dorchester, Roxburyl Brookline, Jamaica Plain, and East Boston were screened for eligibility with the assistance of their nurses. Eligibility criteria included the presence of arthritis and musculoskeletal dysfunction: a potential for improvement by rehabilitation techniques as judged by a physician and a physical therapist; enrollment in the home care program for at least 3 months; and a lack of physical therapy. Distribution of patients is shown in mental illness, or the nurse's judgment of family situation that precluded participation in a study. Of the 337 subjects screened for entry, 244 did not meet the entry criteria (Table 2). Ninety-three subjects (27.6%) met the entry criteria and were invited to participate in the study; 57 (61.3%) agreed to do so. Acceptance rates were higher among females and differed across health centers but not by age group.Characteristics of the participants. Forty-six (81%) of the 57 subjec...

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Assessing limitations in physical function in patients with arthritis

Guccione

Jette

1988

Arthritis & Rheumatism

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

Cited by 12 publications

References 12 publications

Patient education in the rheumatic diseases: A research agenda

Patient education in the rheumatic diseases: A research agenda

Evaluation of comprehensive rehabilitation services for elderly homebound patients with arthritis and orthopedic disability

Assessing limitations in physical function in patients with arthritis

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