The impact on self-efficacy of different types of follow-up care and disease status in patients with rheumatoid arthritis-A randomized trial

Objective: To explore the impact from different types of outpatient care, demographic and disease related variables on self-efficacy beliefs (SE) in patients with established rheumatoid arthritis (RA) after completing an educational program. Methods: 287 adult RA outpatients with low disease activity and moderate physical disability from two Danish rheumatology clinics were randomized for follow-up care. 1: planned rheumatologist's consultations, 2: a shared care model without planned consultations, 3: planned nursing consultations. The participants' SE were assessed by the Danish versions of the Rheumatoid Arthritis Self-Efficacy questionnaire (RASE) and the Arthritis Self-Efficacy Scale CASES). Data were collected at baseline, 3 months and one-year follow up and were explored in random intercept models. Results: Following an educational programme the nursing group increased or stabilized their SE during the first year compared to the medical and the shared care group. SE in the shared care group did not differ significantly from the medical group. No difference between the groups was seen in disease activity at any time. Conclusion: Nursing consultations provide opportunities for maintenance of the patients' SE after patient education. Practice implications: Implementation of nursing consultations as part of follow-up care in patients with stable RA is recommended. (C) 2012 Elsevier Ireland Ltd. All rights reserved.