Rehabilitation Trajectories

Rehabilitation Trajectories. A Study of Rehabilitation Processes Across Health Care Levels in Patients With Rheumatic and Musculoskeletal Diseases

The main aim of this multicentre cohort study is to provide evidence that can be used to improve continuity and quality in rehabilitation practice and rehabilitation processes across health care levels for patients with rheumatic and musculoskeletal diseases (RMDs).

Study Overview

• Status: Completed
• Conditions: Musculoskeletal Disease

Detailed Description

There is an urgent need to develop rehabilitation trajectories that ensure coordination and communication between health care levels, support of self-management and self-monitoring, and follow-up tailored to patients' needs. Such trajectories should be based on evidence from current practice. The "Rehabilitation trajectories" project will systematically explore and describe current practice of planned and implemented follow-up and self-management strategies in primary health care during the first year after rehabilitation for patients with musculoskeletal diseases. Further, a newly developed core set of PROMs designed for evaluation of rehabilitation in RMDs and a self-monitoring web-based system will be tested for feasibility. Knowledge of patients' experiences and use of this self-monitoring system as a self-management and communication tool is needed in order to improve and integrate such e-technology in future care.

The Rehabilitation Trajectory study is a multi-centre study, led by the National Unit on Rehabilitation in Rheumatology and including participants at four rheumatology hospital departments and five specialized rehabilitation institutions. Participants will thus be included from all four health regions in Norway.

The study has five points of assessment. In an electronic portal, delivered by CheckWare, patients will log in with their Bank ID and complete the core set of PROMs at admission, discharge, and 4, 8 and 12 months following discharge.

• Study Type: Observational
• Enrollment (Actual): 524

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 100 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients with rheumatic and musculoskeletal diseases from Norway admitted to rehabilitation at one of the nine participating rehabilitation centres.

Description

Inclusion Criteria:

• Admitted to rehabilitation at one of the nine participating rehabilitation centres with one of the following groups of diagnosis: Inflammatory rheumatic disease, Osteoarthritis, Low back pain, Neck/shoulder pain, Generalized pain syndromes (including fibromyalgia), Osteoporosis, Connective tissue diseases (SLE, Lupus, Myositis etc.), Fractures with need of rehabilitation, or Rehabilitation after orthopaedic surgery. Good proficiency in oral and written Norwegian language. Access to internet and BankID.

Exclusion Criteria:

• Cognitive impairment or severe mental illness.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Goal attainment	Goal attainment will be measures by the Patient Specific Functional Scale. Scale from 0 to 10, were 10 is the best score. Mean score is calculated from all activites scored.	One year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Health-realted quality of life	Health-realted quality of life will be measured by the EQ5D	One year
Physical function	Physical function will be measured by the 30 seconds sit to stand test	One year

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
General Pain	Pain will be measured on a numeric rating scale (NRS). Pain is measured on a subjective scale from 0 to 10, were 0 is no pain and 10 is the worst pain.	One year
Fatigue	Fatigue will be measured on a numeric rating scale (NRS). Fatigue is measured on a subjective scale from 0 to 10, were 0 is no fatiuge and 10 is the worst abount of fatigue.	One year
Motivation for goal attainment	Motivation for goal attainment will be measured on a numeric rating scale (NRS). Motivation is measured on a subjective scale from 0 to 10, were 0 is no motviation and 10 is the best and highest motivation.	One year
Function in daily acitvities	Daily activities will be measured by the Hannover Functional Ability Questionnair	One year
Coping	Coping will be measures by the Effective Musculoskeletal Consumer Scale. The scale goes from 0 to 4, were 0 stated "never" and 4 states "always".	One year
Mental health	Mental health will be measured by the Hopkins Symptoms Checklist	One year
Participation	Participation will be measured by the participation scale in COOP/WONKA	One year

Collaborators and Investigators

• Sponsor: National Resource Center for Rehabilitation in Rheumatology
• Collaborators: Betanien Hospital; North Norway Rehabilitation Center; Haugesund Rheumatism Hosptial AS; Vikersund Rehabilitation Center AS; Meråker Rehabilitation Center; UniCare Jeløy; Sørlandet Hospital; Innlandet HF Konsvinger Hospital; Rehab Vest Rehabilitation Hospital
• Investigators: Study Director: Tore K Kvien, PhD, Diakonhjemmet Hospital

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2015
• Primary Completion (Actual): December 31, 2017
• Study Completion (Actual): December 31, 2017

Study Registration Dates

• First Submitted: November 6, 2018
• First Submitted That Met QC Criteria: November 6, 2018
• First Posted (Actual): November 7, 2018

Study Record Updates

• Last Update Posted (Actual): October 28, 2019
• Last Update Submitted That Met QC Criteria: October 25, 2019
• Last Verified: October 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases
• Other Study ID Numbers: Project nr. 97035

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No