S53 CLINICAL PROFILE, MANAGEMENT STRATEGIES AND OUTCOMES OF PATIENTS WITH RHEUMATIC DISEASES WHO ARE REFERRED TO A MULTIDISCIPLINARY HAND CLINIC

Abstract

Objective: Complex hand function problems in patients with rheumatic diseases may require the expertise of physicians and health professionals from multiple disciplines. The aim of the present study was to describe the characteristics, management strategies and outcomes of patients with rheumatic diseases who were referred to a multidisciplinary hand clinic.

Methods: All consecutive patients with complex hand function problems who were referred to a multidisciplinary hand clinic including a rheumatologist, an orthopaedic surgeon, a rehabilitation specialist, an occupational therapist and a physical therapist were included. Of all patients, sociodemographic characteristics, general disease characteristics, the most troubling impairments and limitations regarding hand function and deformities were recorded at baseline. The following measures of hand function were assessed at baseline and 3 months after treatment: the Sequential Occupational Dexterity Assessment (SODA), the Michigan Hand Outcomes Questionnaire (MHQ), the hand/finger function subscale of the Arthritis Impact Measurement Scales (AIMS), grip strength (Jamar dynamometer) and pain (visual analogue scale, VAS, 0–10 cm).

Results: Over a period of 28 months 69 patients were included. Basic characteristics, characteristics of hand function, impairments and limitations that were most frequently mentioned as well as the advised management strategies were recorded. In 38/54 patients (70%) the advised treatment was executed and 33 of them completed the follow-up assessment.

Conclusion: The most frequently mentioned impairments and limitations of patients with rheumatic diseases and hand function problems pertain to grip ability and grip strength, pain and shaking hands. Management advices, including conservative and surgical treatment, are followed by two-thirds of the patients. On average, patients who are treated improve significantly with respect to grip strength and overall hand function as measured by a questionnaire.