Rheumatoid Arthritis: Nurse-Led Care Effectiveness and Patient Satisfaction

MedicalResearch.com Interview with:
Mwidimi Ndosi, PhD, MSc, BSc (Hons), RN.
Academic & Clinical Unit for Musculoskeletal Nursing (ACUMeN)
Leeds Institute of Rheumatic and Musculoskeletal Medicine
University of Leeds
England

MedicalResearch.com: What are the main findings of the study?

Answer: The aims of this study was to determine the clinical and cost-effectiveness of nurse-led care for people with rheumatoid arthritis.

The main findings were:

(i)             Patients seeing clinical nurse specialists for their rheumatoid arthritis follow-up care do not get an inferior treatment.
(ii)           Nurse-led care is safe and in some aspects presents added value to patients
(iii)          Nurse-led care represents good value for money in terms of disease management for people with RA.

MedicalResearch.com: Were any of the findings unexpected?

Answer: It was expected that nurse-led care would be associated with greater patient satisfaction as this has been shown in other chronic diseases.

It was however surprising to see that patients under nurse-led care saw greater improvement in their disease activity, despite making fewer medication changes than rheumatologist-led care.

MedicalResearch.com: What should clinicians and patients take away from your report?

MedicalResearch.com:  This was a pragmatic trial, assessing the effectiveness of an established practice in the UK and this report provides a robust evidence of its effectiveness. Since in rheumatology, nurse-led care follows a ‘complementary model’, patients are likely to get additional benefits and this model of care should be given a serious consideration in other chronic conditions.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer: Since the future of care for people with rheumatic diseases is likely to involve more multidisciplinary collaboration, further research is should look into ways this model of care can achieve better outcomes with more efficiency in different subgroups of patients.

Citation:

The outcome and cost-effectiveness of nurse-led care in people with rheumatoid arthritis: a multicentre randomised controlled trial

Mwidimi Ndosi, Martyn Lewis, Claire Hale, Helen Quinn, Sarah Ryan, Paul Emery,
Howard Bird, Jackie Hill

Ann Rheum Dis annrheumdis-2013-203403Published Online First: 27 August 2013 doi:10.1136/annrheumdis-2013-203403