Arthritis is a costly disease to society and the individual. The annual costs in the US due to arthritisexceed $86 billion. Nearly 8 million Americans are disabled as a result of their arthritis, making arthritis aprimary cause of disability in the US. Knee osteoarthritis (OA) and rheumatoid arthritis (RA) are majorcauses of arthritis-related disability. Physical activity is a promising weapon in the public health arsenal toimprove the health of persons with arthritis. Our recent work indicates that increased levels of physicalactivity reduced disability progression in an observational cohort of adults with arthritis. Since medical costsdue to arthritis are strongly driven by disability, identifying an implementable physical activity intervention thatreduces disability among persons with arthritis may provide an effective strategy to contain rising health carecosts due to arthritisTo examine disability progression and economic issues relevant to the promotion of physical activity inrheumatic disease, an ancillary study to the Physical Activity Management (PAM) Trial is proposed. ThePAM Trial is an NIH-funded randomized clinical trial enrolling 480 patients with knee OA and RA. Thefunded mission of the PAM Trial is to test the effectiveness in terms of health status of a physical activitymanagement program to augment physician physical activity promotion (PAM group) compared to onlyphysician promotion of physical activity (control group). This ancillary study extends this randomized clinicaltrial beyond clinical outcomes to factors relevant to pubic policy evaluations of this intervention.The proposed ancillary study requests funds to add 1) disability measures, 2) a community-based healthutility assessment of health related quality of life, and 3) medical utilization measures to the funded PAMTrial. These new measures will extend the evaluation of PAM physical activity management beyond itseffect on pain and health status to an assessment of policy-relevant outcomes. Specifically, this randomizedclinical trial will be used to determine if PAM is a cost-effective intervention that reduces disabilityprogression and improves health related quality of life of patients with arthritis. This is key information forpolicy evaluations related to the potential large scale dissemination of the PAM intervention into widespreadpractice. Findings from this study will advance public health and policy efforts to reduce disability, risinghealth care costs, and improve the quality of life among 48 million US adults having arthritis.
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