Background The treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) is based upon the principle of treat-to-target, which requires the measurement of disease activity scores (DAS) every 3 months in order to adjust the treatment. DAS are often performed by non-rheumatologists.
Objectives To evaluate DAS as measured by rheumatologic nurses in the evaluation of patients with RA, PsA and AS.
Methods The study was performed in the Department of Rheumatology of Tel Aviv Medical Center and included 3 steps. Step 1: review of 75 files of patients with RA, PsA and AS in order to evaluate the real performance of the DAS. Step 2: Training nurses to perform DAS. Step 3: comparison of the performance of DAS between a rheumatologist and a nurse on a random sample of patients with RA, PsA and AS
Results Data were retrieved from the files of 50 RA patients, 16 PsA patients and 20 AS patients. DAS was measured by physicians in 30% RA,18% PsA and 70% AS patients. Step2: 2 days were scheduled for training nurses to perform DAS-28 and to help patients respond tol the BASDAI questionnaire. Step 3: performance of DAS-28 for RA and PsA patients, and BASDAI for AS patients. Sixty–six RA patients (mean age: 57±16 years, 68% females), 20 PsA patients (mean age: 58±11 years, 45% females) and 16 AS patients (mean age: 52.2±12 years, 45% females) were evaluated. There were no significant differences in the swollen joint count (2.4±1.3 vs 1.9±1.4), tender joint count (4±4.5 vs 4.8±4.4), patient VAS (30.7±25 vs 31±26) and DAS-28 (3.6±1.6 vs 3.5±1.6) in the RA patients as measured by rheumatologists and nurses. Similar results were observed for PsA patients. For AS patients, since the he BASDAI was filled in by the AS patientsno difference was noticed.
Conclusions After adequate training, nurses are able to measure DAS similarly to rheumatologists. DAS performance by rheumatologic nurses may improve the application of the principle of treat to target.
Disclosure of Interest None declared