Abstract
BACKGROUND: The satisfaction of patients with rheumatoid arthritis (RA) influences disease control, treatment adherence and both physical and psychological well-being, which are key factors for long-term treatment success. However, due to limited physician resources, guideline-based patient-centered care cannot be universally implemented. As a response, the integration of trained rheumatological specialist assistants (RFA) into the care is evaluated as a complementary approach. OBJECTIVE: This study aimed to assess the impact of team-based care on patient satisfaction among individuals with seropositive RA during flares. MATERIAL AND METHODS: In this 12-month multicenter, pragmatic randomized controlled trial, 224 patients were enrolled. Following baseline assessment, five follow-up visits were scheduled. In the intervention group (IG), three of these visits were conducted by RFAs, while the control group (CG) received standard rheumatologist-led care. After 12 months participants were stratified by disease activity (DAS28 < 2.6 vs. ≥ 2.6). A secondary outcome was patient satisfaction, assessed using the ZAP questionnaire. RESULTS: After 12 months the IG reported significantly higher satisfaction in the domains of interaction (p = 0.023), information (p = 0.014), cooperation (p = 0.021), quality of care (p = 0.005) and trust in the healthcare provider (p = 0.028). No significant differences were found for practice organization (p = 0.515) or overall satisfaction (p = 0.084). Similar patterns were observed in the subgroup with active disease but not in patients in remission. CONCLUSION: Team-based care showed a positive impact on multiple dimensions of patient satisfaction in active RA.