Reducing arthritis fatigue impact: Two-year randomised controlled trial of cognitive behavioural approaches by rheumatology teams (RAFT)
| Autor: | Sarah Hewlett, Nicholas L Turner, Bryar Kadir, Emma Dures, Jon Pollock, Clive Rooke, Peter S Blair, Joanna Thorn, Celia Almeida, Alison Hammond, Nicholas Ambler, Ernest Choy, William Hollingworth, Zoe Plummer, John R. Kirwan |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Coping (psychology) Emotions Arthritis Severity of Illness Index law.invention Arthritis Rheumatoid 0302 clinical medicine Randomized controlled trial law Adaptation Psychological Immunology and Allergy Medicine 030212 general & internal medicine Centre for Health and Clinical Research Fatigue Cognition cognitive behavioural therapy Middle Aged Treatment Outcome Patient Satisfaction Rheumatoid arthritis Female BRTC Cognitive Behavioural Therapy Randomised Controlled Trial Adult medicine.medical_specialty Immunology Rheumatoid Arthritis BTC (Bristol Trials Centre) General Biochemistry Genetics and Molecular Biology 03 medical and health sciences Rheumatology Rating scale Internal medicine Humans rheumatoid arthritis fatigue cognitive behavioural therapy randomised controlled trial Aged Patient Care Team 030203 arthritis & rheumatology Cognitive Behavioral Therapy business.industry medicine.disease Self Care Social Class Usual care Physical therapy fatigue business randomised controlled trial |
| Zdroj: | Hewlett, S, Almeida, C, Ambler, N, Blair, P S, Choy, E, Dures, E, Hammond, A, Hollingworth, W, Kadir, B, Kirwan, J, Plummer, Z E, Rooke, C, Thorn, J, Turner, N, Pollock, J 2019, ' Reducing arthritis fatigue impact : Two-year randomised controlled trial of cognitive behavioural approaches by rheumatology teams (RAFT) ', Annals of the Rheumatic Diseases, vol. 78, no. 4, pp. 465-472 . https://doi.org/10.1136/annrheumdis-2018-214469 Annals of the Rheumatic Diseases |
| ISSN: | 0003-4967 1468-2060 |
| DOI: | 10.1136/annrheumdis-2018-214469 |
| Popis: | ObjectivesTo see if a group course delivered by rheumatology teams using cognitive-behavioural approaches, plus usual care, reduced RA fatigue impact more than usual care alone.MethodsMulticentre, 2-year randomised controlled trial in RA adults (fatigue severity>6/10, no recent major medication changes). RAFT (Reducing Arthritis Fatigue: clinical Teams using CB approaches) comprises seven sessions, codelivered by pairs of trained rheumatology occupational therapists/nurses. Usual care was Arthritis Research UK fatigue booklet. Primary 26-week outcome fatigue impact (Bristol RA Fatigue Effect Numerical Rating Scale, BRAF-NRS 0–10). Intention-to-treat regression analysis adjusted for baseline scores and centre.Results308/333 randomised patients completed 26 week data (156/175 RAFT, 152/158 Control). Mean baseline variables were similar. At 26 weeks, the adjusted difference between arms for fatigue impact change favoured RAFT (BRAF-NRS Effect −0.59, 95% CI –1.11 to -0.06), BRAF Multidimensional Questionnaire (MDQ) Total −3.42 (95% CI –6.44 to -0.39), Living with Fatigue −1.19 (95% CI –2.17 to -0.21), Emotional Fatigue −0.91 (95% CI –1.58 to -0.23); RA Self-Efficacy (RASE, +3.05, 95% CI 0.43 to 5.66) (14 secondary outcomes unchanged). Effects persisted at 2 years: BRAF-NRS Effect −0.49 (95% CI −0.83 to -0.14), BRAF MDQ Total −2.98 (95% CI −5.39 to -0.57), Living with Fatigue −0.93 (95% CI −1.75 to -0.10), Emotional Fatigue −0.90 (95% CI −1.44, to -0.37); BRAF-NRS Coping +0.42 (95% CI 0.08 to 0.77) (relevance of fatigue impact improvement uncertain). RAFT satisfaction: 89% scored > 8/10 vs 54% controls rating usual care booklet (pConclusionMultiple RA fatigue impacts can be improved for 2 years by rheumatology teams delivering a group programme using cognitive behavioural approaches.Trial registration numberISRCTN52709998. |
| Databáze: | OpenAIRE |
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