Sumario: | Rheumatoid arthritis (RA) is a chronic rheumatic, autoimmune disease that causes inflammation of the joints and connective tissues. International research estimates that RA affects between 0.5% and 1% of the adult population. Although there have recently been large advances in pharmacological treatments, many patients still have a need for follow-up and rehabilitation. To best organize future rehabilitation service for patients with RA, there is a need for evaluating and comparing the effect of a specialised, multidisciplinary treatment with a non-multidisciplinary approach. The aim of this systematic review is to compare the effect of a multidisciplinary, team-based rehabilitation program, including education, specialised for patients with RA with treatment/training without a multidisciplinary team, or with no special follow-up. We included eleven studies. Six studies were about patient education as sole intervention, and five studies were about multidisciplinary team-based rehabilitation. The main findings from these studies were:1. Patient education delivered as sole intervention, gives an improvement in symptoms, self-efficacy and knowledge about RA at one year follow-up in favour of the intervention group. For other outcomes, patient education showed small or no effects.2. Multidisciplinary team-based rehabilitation showed, for HAQ physical function, an improved score in favour of the control group at one year follow-up. At two years follow-up there still was a tendency towards better scores in the control group, but the difference was no longer significant. For other outcomes, multidisciplinary, team-based rehabilitation showed small or no effect. The documentation about the effect of multidisciplinary team-based rehabilitation is insufficient, and the conclusions are based on findings from small studies with unclear or high risk of bias. It is important to emphasize that no evidence of effect is not the same as evidence of no effect.
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