Nurses’ roles in the management of chronic inflammatory arthritis: a systematic review

Abstract

In 2011 EULAR first published recommendations for the potential role of nurses in the management of patients with rheumatic diseases. To perform a literature update for the role of nurses in the management of chronic inflammatory arthritis (CIA) from 2010 to 2018. A systematic literature review (SLR) was performed according to the PRISMA guidelines, in accordance with the search strategies and eligibility criteria of the EULAR taskforce. The eligibility criteria were “inflammatory arthritis”, “interventions undertaken by nurses” and “relevant outcomes to answer the research questions”. Exclusion criteria were in itself contradictory outcomes, insufficient data, consideration if they did not clearly distinguish between nurses and health professionals or focused on chronic other than rheumatic diseases. Systematic reviews were classified as descriptive and excluded. Quality of selected trials was determined according to Oxford—levels of evidence 2009. A total of 48 articles and 10 abstracts were identified fulfilling the eligibility and exclusion criteria. Recommendation 1 has been well established in Europe so far. New evidence strengthens the recommendation 3, and—at least in part—recommendation 6. High evidence strengthens recommendation 4, especially for outpatients with low and stable disease activity. Some new evidence also exists for recommendations 7 and 8. This SLR reveals new evidence for the role of nurses in managing CIA patients since 2010, especially for RA-patients with low disease activity or in remission.Electronic supplementary materialThe online version of this article (10.1007/s00296-018-4135-9) contains supplementary material, which is available to authorized users.

Health status and self‐management in patients with inflammatory arthritis—A five‐year follow‐up study after nurse‐led patient education

“…In the field of rheumatology, nurses have an important role in the management of chronic inflammatory arthritis (Vivienne & Michael, ) together with medical doctors and other healthcare professionals. The main treatment goal is to reduce disease activity, prevent structural damage and improve functionality and social participation (Smolen, ).…”

“…Patient education is recommended as an integral part of disease management for people with IA (Combe et al, ; Deighton, O'Mahony, Tosh, Turner, & Rudolf, ; Dejaco et al, ; Richette et al, ; Smolen et al, ; van der Heijde et al, ; Zangi et al, ), where long‐term pharmacological treatment (Connelly et al, ) and disease activity self‐assessment are central. In addition to patient education, patients need support after attendance, often provided as follow‐up phone calls or face‐to‐face consultations (Vivienne & Michael, ).…”

Identification of Five Quality Needs for Rheumatology (Text Analysis and Literature Review)

“…Specialized rheumatology nurses provide advice over the phone and offer self-management, education, and counseling for patients (62)(63)(64)(65)(66)(67). In addition, they participate in disease management, monitor disease-modifying treatments, help treat comorbidities and, after special training, give intra-articular injections and prescribe drug treatments (59,(68)(69)(70)(71).…”

Nurses’ roles, interventions, and implications for management of rheumatic diseases

“…Studies conducted on patients with rheumatoid arthritis (RA) have demonstrated that nurse-led care is widely accepted, similarly efficient, and safe as physician-led care. Additionally, from the patient’s point of view, nurse-led care is convenient and easily reachable [ 9 , 10 ]. The development and broad adoption of telehealth initiatives have the potential to create new opportunities for rheumatology nurses and improve accessibility [ 11 ].…”