Follow-up care and adherence to self-management activities in rehabilitation for patients with rheumatic and musculoskeletal diseases: results from a multicentre cohort study

Figures & data

Figure 1. The inclusion process.

Table 1. Descriptive baseline data.

	Baseline data (n = 523)
Demographic variables
Age (years) (mean, SD)	50.3 (11.3)
Gender (female) (n, %)	422 (80.7)
Body mass index (BMI) (mean, SD)	29.4 (8.7)
Comorbidity (yes) (n, %)	375 (71.7)
Duration of disease (years) (mean, SD)	10.9 (11.7)
Education level (>12 years) (n, %)	421 (80.5)
Employed (yes/having a work relation) (n, %)	240 (45.9)
Smoking (yes) (n, %)	118 (22.5)
Use of Scandinavian snus (yes) (n, %)	38 (7.3)
Referral diagnose (n, %)
Inflammatory rheumatic diseases (SpA, PsA, RA)	263 (50.3)
Osteoarthritis	36 (6.9)
Connective tissue diseases	22 (4.2)
Fracture with need for rehabilitation	2 (0.4)
Chronic widespread pain (fibromyalgia)	152 (29.0)
Chronic ow back pain	34 (6.5)
Chronic neck and shoulder pain	9 (1.7)
Osteoporosis	2 (0.4)
Postoperative rehabilitation	3 (0.6)
Physical active on a regular basis (yes) (n, %)	345 (66.0)
Social activities and hobbies on a regular basis (yes) (n, %)	370 (70.7)
Health and function variables from the core set of outcome measures for rehabilitation in musculoskeletal diseases [Instrument]
Physical fitness [30 s sit to stand test] (mean, SD)	13.1 (5.2)
Motivation for goal attainment [Patient Specific Functional Scale (PSFS); Numeric Rating Scale (NRS): Motivation; 0–10; 0 = no motivation] (mean, SD)	7.9 (2.0)
Fatigue [NRS: fatigue; 0–10; 0 = no fatigue] (mean, SD)	5.8 (1.9)
Pain [NRS: pain; 0–10; 0 = no pain] (mean, SD)	6.2 (2.6)
Health-related quality of life [EQ-5D; rating of experienced health status on a Visual Analogue Scale; 0–100; 100 = best status] (mean, SD)	48.3 (17.4)
Mental health [Hopkins Symptom Checklist; (SCL-5); 0–4; 0 = no symptoms] (mean, SD)	1.2 (0.9)
Coping [Effective Musculoskeletal Consumer Scale; (EC-17); 0–100; 100 = best coping skills] (mean, SD)	63.1 (14.8)
Daily activities [Hannover Functional Questionnaire; 0–24; 0 = best function] (mean, SD)	10.2 (4.6)
Social participation [COOP/WONCA; sub-score social activities; 1–5; 1 = best participation] (mean, SD)	2.8 (1.2)

SD: standard deviation; SpA: spondyloarthritis; PsA: psoriatic arthritis; RA: rheumatoid arthritis.

Missing data ranged from 0.0% to 9.4% (for BMI only).

Figure 2. The numbers of participants that self-reported a need and a plan for follow-up care (FU-care) at discharge are shown together with the actual primary health care received during the follow-up year, from specific health care services (n = 429 participants).

Table 2. Prediction model of received follow-up care (FU-care).

	Crude OR (95% CI)	p Value	Adjusted OR (95% CI)	p Value
Age (years), mean (SD)	0.96 (0.93, 0.99)	0.01*	0.97 (0.94, 0.99)	0.02**
Gender (female), n (%)	0.76 (0.37, 1.59)	0.47	0.74 (0.37, 1.48)	0.39
Comorbidities (yes), n (%)	1.03 (0.53, 2.01)	0.93
Education (>12 years), n (%)	1.24 (0.53, 2.74)	0.59
Employed (yes), n (%)	1.18 (0.63, 2.18)	0.61
Smoking (yes), n (%)	1.11 (0.55, 2.26)	0.77
Scandinavian snus (yes), n (%)	2.20 (0.89, 5.45)	0.09*	2.23 (0.92, 5.39)	0.08
Physical active on a regular basis (yes), n (%)	1.17 (0.64, 2.14)	0.60
Social activities and hobbies on a regular basis (yes), n (%)	1.94 (1.06, 3.55)	0.03*	2.00 (1.14, 3.51)	0.02**
Physical fitness [30 s sit to stand test], mean (SD)	0.99 (0.93, 1.06)	0.86
Motivation for goal attainment [Patient Specific Functional Scale (PSFS); Numeric Rating Scale: Motivation; 0–10; 0 = no motivation] (mean, SD)	1.03 (0.90, 1.18)	0.67
Fatigue [Numeric Rating Scale: Fatigue; 0–10; 0 = no fatigue] (mean, SD)	0.93 (0.81, 1.07)	0.31
Pain [Numeric Rating Scale: Pain; 0–10; 0 = no pain] (mean, SD)	0.95 (0.79, 1.15)	0.60
Health-related quality of life [EQ-5D; Rating of Experienced Health Status on a Visual Analogue Scale; 0–100; 100 = best status] (mean, SD)	1.01 (0.99, 1.03)	0.54
Mental health [Hopkins Symptom Checklist; (SCL-5); 0–4; 0 = no symptoms] (mean, SD)	0.84 (0.59, 1.19)	0.32
Coping [Effective Musculoskeletal Consumer Scale; (EC-17); 0–100; 100 = best coping skills] (mean, SD)	1.04 (1.01, 1.06)	0.01*	1.04 (1.02, 1.07)	<0.001**
Daily activities [Hannover Functional Questionnaire; 0–24; 0 = best function] (mean, SD)	1.04 (0.95, 1.12)	0.42
Social participation [COOP/WONCA; sub-score social activities; 1–5; 1 = highest participation] (mean, SD)	1.13 (0.85, 1.51)	0.39

SD: standard deviation; OR: odds ratio.

* <0.25.

** <0.05.

Table 3. Prediction model of adherence to self-management activities (SMAs).

	Crude OR (95% CI)	p Value	Adjusted OR (95% CI)	p Value
Age (years), mean (SD)	1.03 (1.00, 1.05)	0.03*	1.03 (1.01, 1.05)	0.01**
Gender (female), n (%)	0.98 (0.56, 1.70)	0.94	0.99 (0.57, 1.70)	0.96
Comorbidities (yes), n (%)	0.99 (0.60, 1.63)	0.96
Education (>12 years), n (%)	1.02 (0.58, 1.82)	0.94
Employed (yes), n (%)	1.05 (0.65, 1.82)	0.85
Smoking (yes), n (%)	1.63 (0.95, 2.79)	0.08*	1.59 (0.95, 2.67)	0.08
Scandinavian snus (yes), n (%)	0.50 (0.22, 1.14)	0.10*	0.52 (0.23, 1.16)	0.11
Physical active on a regular basis (yes), n (%)	3.86 (2.39, 6.22)	<0.001*	3.84 (2.41, 6.12)	<0.001**
Social activities and hobbies on a regular basis (yes), n (%)	1.66 (1.01, 2.74)	0.05*	1.66 (1.02, 2.71)	0.04**
Physical fitness [30 s sit to stand test], mean (SD)	0.98 (0.93, 1.02)	0.31
Motivation for goal attainment [Patient Specific Functional Scale (PSFS); Numeric Rating Scale: Motivation; 0–10; 0 = no motivation] (mean, SD)	0.93 (0.83, 1.05)	0.24*	0.93 (0.83, 1.04)	0.18
Fatigue [Numeric Rating Scale: Fatigue; 0–10; 0 = no fatigue] (mean, SD)	0.99 (0.90, 1.09)	0.79
Pain [Numeric Rating Scale: Pain; 0–10; 0 = no pain] (mean, SD)	1.16 (1.01, 1.33)	0.04*	1.14 (1.00, 1.30)	0.05**
Health-Related Quality of Life [EQ-5D; Rating of Experienced Health Status on a Visual Analogue Scale; 0–100; 100 = best status] (mean, SD)	0.99 (0.98, 1.01)	0.25*	0.99 (0.98, 1.01)	0.18
Mental health [Hopkins Symptom Checklist; (SCL-5); 0–4; 0 = no symptoms] (mean, SD)	0.78 (0.59, 1.04)	0.09*	0.79 (0.61, 1.02)	0.06
Coping [Effective Musculoskeletal Consumer Scale; (EC-17); 0–100; 100 = best coping skills] (mean, SD)	1.00 (0.98, 1.02)	0.79
Daily activities [Hannover Functional Questionnaire; 0–24; 0 = best function] (mean, SD)	0.97 (0.91, 1.02)	0.24*	0.99 (0.94, 1.04)	0.59
Social participation [COOP/WONCA; sub-score social activities; 1–5; 1 = highest participation] (mean, SD)	1.10 (0.88, 1.36)	0.40

SD: standard deviation; OR: odds ratio.

* <0.25.

** <0.0.