Evidence map›Paper›PMID 41396281›Full record

Trial reportRheumatology international2025

Effectiveness and cost-effectiveness of a multimodal, physiotherapist-led, vocational intervention for people with rheumatoid arthritis or axial spondyloarthritis and a reduced work ability: a randomized, controlled trial.

N F Bakker, J Knoop, W B van den Hout, N Hutting, J A Engels, J B Staal, M van der Leeden, A Boonen, A Willemze, M T Nurmohamed and 3 more

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Rheumatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

N F BakkerDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P. O. Box 9600, Leiden, 2300 RC, The Netherlands. n.f.bakker@lumc.nl.ORCID http://orcid.org/0000-0001-9203-9348
J KnoopMusculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-2464-9037
W B van den HoutBiomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.ORCID http://orcid.org/0000-0002-6425-0135
N HuttingResearch Group Occupation and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-6164-6265
J A EngelsResearch Group Occupation and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0003-3292-4702
J B StaalResearch Group Occupation and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-0083-6380
M van der LeedenReade, Rehabilitation and Rheumatology, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0001-6465-0983
A BoonenDepartment of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.ORCID http://orcid.org/0000-0003-0682-9533
A WillemzeDepartment of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam, The Netherlands.ORCID http://orcid.org/0009-0009-5680-8782
M T NurmohamedAmsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-6274-1934
T P M Vliet VlielandDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P. O. Box 9600, Leiden, 2300 RC, The Netherlands.ORCID http://orcid.org/0000-0001-6322-3859
M G J GademanDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P. O. Box 9600, Leiden, 2300 RC, The Netherlands.ORCID http://orcid.org/0000-0002-6106-3385
S F E van WeelyDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P. O. Box 9600, Leiden, 2300 RC, The Netherlands.ORCID http://orcid.org/0000-0001-8560-4687

Funding

Dutch Arthritis Society 2019-09-01Koninklijk Nederlands Genootschap voor Fysiotherapie 2019-09-01
6 · The paper itself

Abstract

To evaluate the (cost-)effectiveness of a physiotherapist-led, multimodal vocational intervention compared to usual care in adults with rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA) experiencing reduced work ability. (Self-)employed people with RA or axSpA and reduced work ability were randomized to a 12-month vocational intervention or usual care. Assessments were conducted at baseline, 3, 6, and 12 months. Primary outcome was the Work Ability index Single-item Scale (WAS) at 12 months. Secondary outcomes included additional work-related and clinical outcomes. Cost-effectiveness was evaluated using the EuroQol to estimate quality-adjusted life years (QALYs), alongside healthcare use and productivity data. Primary analyses followed an intention-to-treat approach. A total of 140 participants (80 RA, 60 axSpA) were randomized 1:1 to the intervention or control group. At 12 months, the intervention showed no significant benefits over usual care on the WAS (estimated mean difference (MD): 0.40, 95% confidence interval (CI): - 0.22, 1.01) or any of the secondary outcomes. The QALYs were in favor of the intervention group by 0.05. The mean intervention costs were €395 per participant (90% usage, mean 9.5 sessions). After 12 months, the societal costs were €4324 lower in the intervention group (95% CI €-8169, €-479), mainly due to higher medication and presenteeism costs in the control group. At a willingness-to-pay threshold of €20.000/QALY, the intervention had a 99% probability of being cost-effective compared to usual care. While the intervention did not affect work ability in individuals with RA or axSpA, it outperformed usual care from a health-economic perspective, demonstrating its cost-effectiveness and potential value. International Clinical Trial Registry Platform (ICTRP) registration link: ICTRP Search Portal.

Indexed as

Arthritis, RheumatoidAxial SpondyloarthritisPhysical TherapistsPhysical Therapy ModalitiesRehabilitation, VocationalAbsenteeismAdultCost-Benefit AnalysisFemaleHealth Care CostsHumansMaleMiddle AgedQuality-Adjusted Life YearsTime FactorsTreatment OutcomeAxial spondyloarthritisCost-utilityPhysical therapy modalitiesRandomized controlled trialRheumatoid arthritisVocational rehabilitation

Identifiers

PMID41396281

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.