Background Nursing Consultations in Rheumatology (NCR) are organizational care models that provide care centred on the rheumatology patient within the scope of a nurse's abilities.
Objectives To analyze the effectiveness and quality of care of NCR.
Methods National multicenter observational prospective cohort study one year follow-up, comparing patients attending rheumatology services with and without NCR. NCR was defined by the presence: 1) Office itself; 2) at least one dedicated nurse, albeit part-time; 3) own agenda citation; and 4) phone.
Variables included were (baseline, 6 and 12 months): a) Clinical activity, research and training, infrastructure of unit and resources of NCR); b) Socio-demographics, work productivity (WPAI), assessment of rheumatic disease, use of services and treatments, quality of life, knowledge of the disease and treatment and perceived quality of care. Analysis: Chi square, Fischer's test, t-Student test, Mann–Whitney U test, Wilcoxon and McNemar's tests were used.
Results A total of 393 patients were included: 181NCR and 212 not NCR, corresponding to 39 units, 21 with NCR and 18 without NCR (age 53±11,8 vs 56±13,5 years); females 70% vs 61% and AR 78.5% vs 75,5%. Statistically significant differences were found in patients attended in sites without NCR for the following parameters: higher CRP level (5.9±8.3 vs 4.8±7.8; p<0.005), global disease patient VAS (3.6±2.3 vs 3.1±2.4), physician VAS (2.9±2.1 vs 2.3±2.1; p<0.05) and use of primary care consultations (2.7±5.4 vs 1.4±2.3; p<0.001), worse work productivity, knowledge of the disease, treatment adherence and perceived quality. There were no significant differences in the other parameters between the two groups.
Conclusions The presence of NCR in the Rheumatology unit contributes to a lower frequency of primary care consultations, improves clinical outcomes and quality of life of patients with rheumatic diseases, also the knowledge of the disease, leading to an improvement of patient adherence to treatment and perceived quality of care.
Disclosure of Interest None declared
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