Article Text

PDF
OP0195-HPR Nurse-led rheumatology clinic versus rheumatologist clinic in monitoring of biological therapy– a randomised controlled study
  1. I. Larsson1,2,
  2. B. Arvidsson3,
  3. B. Fridlund1,
  4. A. Teleman4,
  5. S. Bergman2
  1. 1School of Health Sciences, Jönköping University, Jönköping
  2. 2R & D- Centre, R & D-Centre, Spenshult, Oskarström
  3. 3School of Social and Health Sciences, Halmstad University, Halmstad
  4. 4Spenshult Hospital for Rheumatic diseases, Spenshult Hospital, Oskarström, Sweden

Abstract

Background Patients with rheumatic diseases treated with biological therapy are usually followed up by rheumatologists. Nurse-led rheumatology clinics have been proposed for patients with low disease activity or in remission.

Objectives To compare treatment outcomes from a nurse-led rheumatology clinic and a rheumatologist clinic for patients treated with biological therapy with low disease activity or in remission.

Methods In a prospective controlled study 107 patients were randomised into two groups with six months follow up to a nurse-led rheumatology clinic (intervention group; n=53) or to a rheumatologist clinic (control group; n=54). Inclusion criteria were ongoing biological therapy and Disease Activity Score 28 (DAS28) ≤3.2. All patients met the rheumatologist at inclusion and after 12 months. In the nurse-led rheumatology clinic the patients’ disease activity was assessed by examination of tender or swollen joints and laboratory tests. The rheumatology nurse also had a dialogue concerning the patient’s needs with regard to drug therapy, smoking habits and psychosocial aspects. Main outcome was disease activity measured by DAS28.

Results After 12 months 97 patients completed the study. The patients had mean age of 55.4 years, disease duration of 16.7 years, and DAS28 was 2.1, with no significant differences between the two groups. In change of DAS28 there were no differences (p=0.66) between the intervention group (0.14) or control group (0.20) from inclusion to 12 months. There were no differences (p>0.05) in mean change after 12 months in ESR, swollen and tender joints, global health and pain visual analogue scales (VAS) or Health Assessment Questionnaire (HAQ) between the patients followed up at the nurse-led rheumatology clinic or the rheumatologist clinic, see table.

Table 1. Comparison of the two groups intervention group (Nurse-led rheumatology clinic) and control group (Rheumatologist clinic)

Conclusions Patients with low disease activity or in remission, in biological therapy could be monitored by a nurse-led rheumatology clinic without any differences in outcome as measured by DAS28.

Disclosure of Interest None Declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.