Coping Skills Training for Early Rheumatoid Arthritis - Full Text View

Purpose

Rheumatoid arthritis (RA) is the most common inflammatory arthritis and a major health problem. Medical treatments are now being used much earlier in the course of RA, but these treatments do not address the challenges of coping with the early stages of this disease. This study will determine whether a comprehensive coping skills training program can decrease pain, psychological disability, and physical disability in patients with early RA.

Condition	Intervention
Rheumatoid Arthritis	Behavioral: Comprehensive Coping Skills Training Behavioral: Arthritis Education Sessions Behavioral: Standard Care

MedlinePlus related topics:

Rheumatoid Arthritis

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Other, Randomized, Single Blind (Outcomes Assessor), Active Control, Factorial Assignment, Efficacy Study

Official Title:	Coping Skills Training for Early Rheumatoid Arthritis

Further study details as provided by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS):

Primary Outcome Measures:

Pain [ Time Frame: Measured at Week 10 ] [ Designated as safety issue: No ]
Psychological disability [ Time Frame: Measured at Week 10 ] [ Designated as safety issue: No ]
Physical disability [ Time Frame: Measured at Week 10 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Erythrocyte sedimentation rate [ Time Frame: Measured at Week 10 ] [ Designated as safety issue: No ]
Joint tenderness count [ Time Frame: Measured at Week 10 ] [ Designated as safety issue: No ]
Grip strength [ Time Frame: Measured at Week 10 ] [ Designated as safety issue: No ]
Physician assessment of disease activity [ Time Frame: Measured at Week 10 ] [ Designated as safety issue: No ]
C reactive protein [ Time Frame: Measured at Week 10 ] [ Designated as safety issue: No ]

Estimated Enrollment:	225
Study Start Date:	February 2003
Estimated Study Completion Date:	December 2008
Estimated Primary Completion Date:	December 2008 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: Experimental Participants will receive comprehensive pain coping skills.	Behavioral: Comprehensive Coping Skills Training 10 weekly, 80-minute coping skills treatment sessions, followed by a series of six biweekly follow-up telephone calls.
2: Active Comparator Participants will receive arthritis education.	Behavioral: Arthritis Education Sessions 10 weekly, 80-minute treatment sessions, followed by a series of six biweekly follow-up telephone calls. Participants will learn about the nature and treatment of rheumatoid arthritis as well as the benefits of exercise and joint protection.
3: Active Comparator Participants will receive standard care.	Behavioral: Standard Care Usual care from participants' rheumatologists but no treatment sessions.

Detailed Description:

RA is a serious and complex disease that taxes patients' coping resources. Patients with RA must cope with pain and with major life stresses, including disruptions in their health, work, family, and marital functioning.

Recognition of the morbidity and mortality associated with RA has increased interest in early interventions. Rapid disease progression during the first few years of RA taxes patients' coping efforts. Those who cope well with the early stages of RA can maintain an active and rewarding lifestyle. Those who do not may become depressed, decrease physical activity, and develop a sedentary, restricted lifestyle that contributes to long-term disability and overdependence on family and friends.

This study will evaluate the effectiveness of early coping skills training (CST) to enhance self-efficacy, prepare patients to cope with future pain, and prevent the development of behaviors that may increase long-term psychological distress and physical disability. The comprehensive CST intervention combines traditional CST with CST components tailored to rheumatoid arthritis patients. It is designed to teach traditional coping skills such as attention diversion, cognitive restructuring, and changes in activity to control and decrease pain.

Participants will be randomized to one of three study groups: 1) comprehensive pain coping skills training; 2) arthritis education; or 3) standard care. Study participants assigned to the comprehensive CST and the arthritis education groups will be asked to attend ten weekly, 80-minute treatment sessions. These ten sessions will be followed by a series of six biweekly follow-up telephone calls.

Study participants in the arthritis education group will learn about the nature and treatment of rheumatoid arthritis as well as the benefits of exercise and joint protection. Study participants in the standard care group will continue to receive care from their rheumatologists but will not participate in any treatment sessions.

Measures of pain, disability, pain coping, and self efficacy will be collected during evaluation sessions before and after the treatment phase. Participants attend 5 evaluation sessions and will be followed for 18 months.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria

Meet at least 4 of the 7 criteria for RA classification based on the 1987 American College of Rheumatology criteria
Onset of RA symptoms within 2 years of study entry

Exclusion Criteria

Known organic disease that significantly affects function
Rheumatic disorders in addition to RA that significantly affect function

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00056394

Locations


United States, North Carolina
	Duke University Medical Center
	Durham, North Carolina, United States, 27710

Sponsors and Collaborators

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

Investigators


Principal Investigator:	Francis J. Keefe, PhD	Duke University

More Information

Responsible Party:	Duke Medical Center ( Dr. Francis Keefe )
Study ID Numbers:	R01 AR47218, NIAMS-086
First Received:	March 11, 2003
Last Updated:	September 3, 2008
ClinicalTrials.gov Identifier:	NCT00056394
Health Authority:	United States: Federal Government

Keywords provided by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS):

Early Rheumatoid Arthritis

Coping Skills Training

Pain

Physical Disability

Psychological Disability

Daily Diary Measures

Study placed in the following topic categories:

Autoimmune Diseases

Musculoskeletal Diseases

Joint Diseases

Arthritis

Connective Tissue Diseases

Arthritis, Rheumatoid

Pain

Rheumatic Diseases

Additional relevant MeSH terms:

Immune System Diseases

ClinicalTrials.gov processed this record on November 20, 2008

Sponsored by:	National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information provided by:	National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
ClinicalTrials.gov Identifier:	NCT00056394