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Abstract：
OBJECTIVE: To compare the effectiveness of a structured goal-setting and tailored follow-up rehabilitation intervention with existing rehabilitation in patients with rheumatic and musculoskeletal diseases.
METHODS: A pragmatic stepped-wedge cluster randomized trial.
METHODS: Eight rehabilitation centers in secondary healthcare, Norway.
METHODS: A total of 374 adults with rheumatic and musculoskeletal diseases were included in either the experimental (168) or the control group (206).
METHODS: A new rehabilitation intervention which comprised structured goal setting, action planning, motivational interviewing, digital self-monitoring of goal progress, and individual follow-up support after discharge according to patients\' needs and available resources in primary healthcare (the BRIDGE-intervention), was compared to usual care.
METHODS: Patient-reported outcomes were collected electronically on admission and discharge from rehabilitation, and after 2, 7, and 12 months. The primary outcome was patients\' goal attainment measured by the Patient Specific Functional Scale (0-10, 10 best) at 7 months. Secondary outcome measures included physical function (30-s Sit-To-Stand test), health-related quality of life (EQ-5D-5L-index), and self-assessed health (EQ-VAS). The main statistical analyses were performed on an intention-to-treat basis using linear mixed models.
RESULTS: No significant treatment effects of the BRIDGE-intervention were found for either primary (Patient Specific Functional Scale mean difference 0.1 [95% CI: -0.5, 0.8], p = 0.70), or secondary outcomes 7 months after rehabilitation.
CONCLUSIONS: The BRIDGE-intervention was not shown to be more effective than existing rehabilitation for patients with rheumatic and musculoskeletal diseases. There is still a need for more knowledge about factors that can improve the quality, continuity, and long-term health effects of rehabilitation for this patient group.
METHODS: A pragmatic stepped-wedge cluster randomized trial.
METHODS: Eight rehabilitation centers in secondary healthcare, Norway.
METHODS: A total of 374 adults with rheumatic and musculoskeletal diseases were included in either the experimental (168) or the control group (206).
METHODS: A new rehabilitation intervention which comprised structured goal setting, action planning, motivational interviewing, digital self-monitoring of goal progress, and individual follow-up support after discharge according to patients\' needs and available resources in primary healthcare (the BRIDGE-intervention), was compared to usual care.
METHODS: Patient-reported outcomes were collected electronically on admission and discharge from rehabilitation, and after 2, 7, and 12 months. The primary outcome was patients\' goal attainment measured by the Patient Specific Functional Scale (0-10, 10 best) at 7 months. Secondary outcome measures included physical function (30-s Sit-To-Stand test), health-related quality of life (EQ-5D-5L-index), and self-assessed health (EQ-VAS). The main statistical analyses were performed on an intention-to-treat basis using linear mixed models.
RESULTS: No significant treatment effects of the BRIDGE-intervention were found for either primary (Patient Specific Functional Scale mean difference 0.1 [95% CI: -0.5, 0.8], p = 0.70), or secondary outcomes 7 months after rehabilitation.
CONCLUSIONS: The BRIDGE-intervention was not shown to be more effective than existing rehabilitation for patients with rheumatic and musculoskeletal diseases. There is still a need for more knowledge about factors that can improve the quality, continuity, and long-term health effects of rehabilitation for this patient group.
摘要：
目的：比较在风湿性和肌肉骨骼疾病患者中，结构化目标设定和量身定制的随访康复干预与现有康复的有效性。
方法：一项实用的阶梯式楔形整群随机试验。
方法：二级医疗保健的八个康复中心，挪威。
方法：总共374名患有风湿性和肌肉骨骼疾病的成年人被纳入实验组（168）或对照组（206）。
方法：一种新的康复干预措施，包括结构化的目标设定，行动计划,动机性面试，目标进度的数字自我监控，根据患者的需求和初级医疗保健的可用资源（桥梁干预），以及出院后的个人随访支持，与常规护理相比。
方法：患者报告的结果在入院和康复出院时以电子方式收集，2、7和12个月后。主要结果是在7个月时通过患者特异性功能量表（0-10，10最佳）测量患者的目标达成情况。次要结果指标包括身体功能（30s站立测试），健康相关生活质量（EQ-5D-5L指数），和自我评估健康（EQ-VAS）。主要统计分析是使用线性混合模型在意向治疗的基础上进行的。
结果：对于任一原发性患者均未发现BRIDGE干预措施的显着治疗效果（患者特定功能量表平均差异0.1[95％CI：-0.5，0.8]，p=0.70),或次要结果7个月后康复。
结论：对于风湿性疾病和肌肉骨骼疾病患者，桥梁干预并未显示出比现有康复更有效。仍然需要更多关于可以提高质量的因素的知识，连续性,以及康复对该患者组的长期健康影响。
方法：一项实用的阶梯式楔形整群随机试验。
方法：二级医疗保健的八个康复中心，
方法：总共374名患有风湿性和肌肉骨骼疾病的成年人被纳入实验组（168）或对照组（206）。
方法：一种新的康复干预措施，包括结构化的目标设定，
方法：患者报告的结果在入院和康复出院时以电子方式收集，
结果：对于任一原发性患者均未发现BRIDGE干预措施的显着治疗效果（患者特定功能量表平均差异0.1[95％CI：-0.5，0.8]，
结论：对于风湿性疾病和肌肉骨骼疾病患者，桥梁干预并未显示出比现有康复更有效。
