Navigation Links
Specialist nurses as good as doctors in managing rheumatoid arthritis patients
Date:8/28/2013

Patients attending clinical nurse specialist clinics do not get inferior treatment to that offered by consultant rheumatologists, the results of a major new clinical trial have revealed.

The results of the multi-centre trial at the University of Leeds, funded by Arthritis Research UK, showed that there may be some clinical benefit to people with rheumatoid arthritis, whose condition is managed in clinics run by rheumatology clinical nurse specialists, especially with respect to their disease activity, pain control, physical function and general satisfaction with their care.

Rheumatoid arthritis is a chronic inflammatory disease, which if untreated may lead to severe disability or death. However, the management of the disease has changed significantly over the past ten years due to better understanding of the disease process, an emphasis on early diagnosis, intensive treatment and the use of more efficacious drug therapies.

The nation-wide trial was led by Dr Mwidimi Ndosi, of the University's Institute of Rheumatic and Musculoskeletal Medicine, and former University academic Dr Jackie Hill. It compared the outcomes of 180 people with rheumatoid arthritis in 10 out-patient clinics around the UK, half run by clinical nurse specialists, and the other by rheumatologists.

In both groups the nurse or doctor took a patient history, carried out a physical examination, discussed pain control, change of drugs or dose (including steroid injections) and offered patient education and psychosocial support. The nurse-led clinics' appointment times were on average longer than the consultants' (20 vs 15 minutes).

The results of the study, published in the Annals of the Rheumatic Diseases, found that although the nurses made fewer changes to a patient's medication and ordered fewer x-rays and steroid injections, their patients saw greater improvement in disease activity than those under rheumatologists' care. Nurses also provided patient education and psychosocial support more frequently than rheumatologists, and their patients also had fewer unplanned hospital admissions or visits to accident and emergency units.

"The results of this study show that clinics run by rheumatology clinical nurse specialists can manage many people with rheumatoid arthritis without any reduction in the quality of care and treatment," said Dr Ndosi.

In addition to better improvements in the disease activity, nurse-led clinics had overall lower healthcare costs, representing a cost-effective service. The economic evaluation took into account healthcare resource use, including consultation costs, investigations, hospital admissions and treatments including over-the-counter medications.

Interestingly, throughout the 12-month follow-up period, the proportion of patients receiving expensive biologic drug treatment remained more or less constant in the nurse-led clinics, while that of rheumatologist-led clinics doubled.

"The development of the role of clinical nurse specialist in rheumatology has resulted in great improvements in rheumatology service, providing a high quality, accessible and person-centred care to people with rheumatoid arthritis," said Dr Hill.

"The results of this research are encouraging, demonstrating that this model of care is effective, safe, and associated with more patient satisfaction. At a time when deficiencies have come to light in some areas of the NHS, it's good to know that in rheumatology there are high levels of satisfaction with the care we provide."

Professor Alan Silman, medical director of Arthritis Research UK commented: "Rheumatoid arthritis is, despite modern treatment, a chronic condition requiring long-term expert professional care to help patients manage their symptoms and control disease. This care necessarily involves many different healthcare professionals.

"Why this study is so important is that it shows that specialist trained nurses can improve outcome, enhance the patient experience and reduce costs when compared to conventional doctor-led services.

"There will obviously always be a place for specialist medical input at certain times in the patient journey, but this study shows the importance of specialist rheumatology team work, and is a future model of care which requires serious consideration for widespread implementation within the NHS."


'/>"/>

Contact: Ben Jones
B.P.Jones@leeds.ac.uk
44-113-343-8059
University of Leeds
Source:Eurekalert

Related medicine news :

1. Internal medicine physician specialists release policy paper on reforming Medicaid
2. U.S.A. Hurdle Specialist Kellie Wells has Joined Elite Athletes Tiger Woods, Hines Ward and Takaishi Saito in Using Cell Therapy
3. Texas Back Institute Becomes Official Spine Specialist for FC Dallas and the Frisco RoughRiders
4. Triggers study evaluates regular staff, ICU specialists
5. Leading cancer specialists from Europe and beyond recognized at ESMO 2012
6. Soaring U.S. Spinal Care Spending Due to Specialists: Study
7. Specialist urologists should handle vasectomy reversal cases says 10-year study
8. A Media Representative for Dr. Castro Announces New Updates on the Dental Implants Specialist in Rancho Cucamonga's Website with Information on Digital X-Rays
9. Best Wheelchair Lifts for Your Porch or Deck: Tips from Aging in Place Specialist, Gordon Raney
10. Apex Mold Specialists Earns Esteemed 2012 Angie’s List Super Service Award
11. Women and Infants Maternal-Fetal Medicine specialist selected for editorial team
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/24/2017)... ... March 24, 2017 , ... “The Communion of ... people of God in congregations across the United States. “The Communion of ... in 1964 who has served congregations in seven states throughout his long career ...
(Date:3/23/2017)... Virginia (PRWEB) , ... March 23, 2017 , ... ... public health services to their communities, 16 more public health departments have been ... week’s decisions bring another 4.5 million people into the expanding network of communities ...
(Date:3/23/2017)... New York, NY (PRWEB) , ... March 23, 2017 , ... 82% of adults are ... every 3 kids do not brush their teeth the minimum two times a day that ... teeth; with students missing 51 million hours of school and adults missing 164 million hours ...
(Date:3/23/2017)... ... March 23, 2017 , ... ... Angeles based healthcare technology company California Healthcom Group (CHG). , The HUG ... healthcare arena. With headquarters in California, CHG is a growing, internationally recognized healthcare ...
(Date:3/23/2017)... ... 2017 , ... After raising more than $1.135 million ($1,479,231 AUD) from nearly ... in crowdfunding history, has established a U.S. Headquarters in New York City, FaceCradle ... , “We’re excited to be operating on U.S. shores, where most of our initial ...
Breaking Medicine News(10 mins):
(Date:3/23/2017)... Research and Markets has announced the addition of the ... Technique, Repair Procedure By Technique, By Region, By Country (2016-2021)" ... ... at a CAGR of 13.35% during 2016-2021 The strong ... growth in population with heart disease and rising advances in minimally ...
(Date:3/23/2017)... INDIANAPOLIS , March 23, 2017  Eli ... the William Sansum Diabetes Center have established a research ... by diabetes through enhanced research, education and care. ... disease bears a disproportionate weight on Latino families in ... David Kerr , M.D., FRCPE, director of Innovation and ...
(Date:3/23/2017)... -- Summary Global Markets ... Primary Hyperoxaluria - Pipeline Review, H1 2017, provides ... System And Sex Hormones) pipeline landscape. Primary ... kidney and bladder stones. It results from the ... blood in the urine, pain when urinating, fever, ...
Breaking Medicine Technology: