LAUSR

Background Patients with rheumatoid arthritis (RA) have high amounts of daily sitting time and do not meet recommendations for moderate to vigorous physical activity (PA). Previously, we reported results from a randomised controlled trial (RCT) investigating the efficacy of a four-month individually tailored behavioural intervention, targeting reduction of sedentary behaviour (SB) in patients with RA.1 The four-month post intervention results showed that patients in the intervention group reduced their daily sitting time; moreover patient-reported outcomes (PROs) and total cholesterol levels improved compared to the usual lifestyle control group. Objectives To investigate 18 month post-intervention efficacy of the four-month individually tailored, behavioural intervention on daily sitting time in patients with RA. Methods In the observer-blinded RCT, we included 150 RA patients from a rheumatology outpatient clinic. The intervention group (n=75) received three motivational counselling sessions and tailored text messages aimed at increasing light intensity PA through reduction of SB. The control group (n=75) maintained usual lifestyle. Primary outcome was change from baseline in objectively measured daily sitting time. Secondary outcomes included PROs and cardio-metabolic biomarkers (blood pressure, lipids and HbA1c). All outcome measures were analysed with a mixed effects repeated measures ANCOVA model on the intention-to-treat population. Results At 22 months follow-up from baseline, 12 participants were lost to follow-up (three and nine, respectively). Compared to baseline, daily sitting time in the intervention group decreased 1.10 h/day, and in the control group it increased 1.32 h/day; between-group difference of −2.43 h/day (95% CI: −2.99 to −1.86; p<0.0001) in favour of the intervention group. Likewise, for most secondary outcomes between-group results favoured intervention: VAS-pain: −15.51 mm (−23.42 to −7.60), VAS-fatigue: −12.30 mm (−20.71 to −3.88), physical function: −0.39 HAQ-units (−0.53 to −0.26), total cholesterol: −0.86 (-1.03 to −0.68), triglyceride: −0.26 (-0.43 to −0.09) and HbA1c: −1.15 (-1.39 to −0.91) mmol/l. Conclusions Even 18 months after completed intervention results showed an effect on daily sitting time and improvements in PROs, lipids and HbA1c in favour of the intervention group. Findings suggest that an individually tailored, behavioural approach may be beneficial in promoting health in addition to current clinical practise for patients with RA. Reference [1] Thomsen T, et al. The efficacy of motivational counselling and SMS reminders on daily sitting time in patients with rheumatoid arthritis: A randomised controlled trial. Ann Rheum Dis2017;76(9):1603–1606. Disclosure of Interest None declared