Outcomes for patients with RA: a rheumatology nurse practitioner clinic compared to standard outpatient care

Abstract

The findings from this research confirm that care from the RNP is both effective and safe. Furthermore, a specialist RNP can bring additional benefits in the form of greater symptom control and enhanced patient self-care.

The effectiveness of nurse-led care in people with rheumatoid arthritis: A systematic review

“…Results from some of the outcomes could not be pooled because they were assessed using different measures (for example; Hill (1997) used the Leeds Satisfaction Questionnaire to measure satisfaction but used a different questionnaire). In some studies, different measures were used to assess different aspects of the same outcome and it would not be appropriate to combine the results of, for example, disease activity measured by plasma viscosity (Hill et al, 1994, Hill et al, 2003 with those measured by DAS28 (Hill et al, 2003, Ryan et al, 2006, Tijhuis et al, 2002. The outcomes that could not be combined were summarised in a tabular form with corresponding sizes of effect, 95% confidence intervals and P-values where applicable.…”

“…The 7 included articles (Hill, 1997, Hill et al, 1994, Hill et al, 2003, Ryan et al, 2006, Tijhuis et al, 2002 represented only 4 RCTs. All studies were conducted in the UK and the Netherlands and the pooled sample size was 431 patients (nurse-led care = 181, usual care = 250).…”

“…The second study (Hill et al, 2003) was a 48-week parallel RCT where the outcomes of nurse-led care were compared to those of 4 junior hospital doctors. Participants were 80 adults with RA with both mild and moderate/severe disease activity (39 nurse-led care/41 usual care, mean age = 57 years, male:female ratio = 17:63).…”

“…Three studies reported disease activity using DAS28 (Hill et al, 2003, Ryan et al, 2006 and 2 used plasma viscosity and Ritchie articular index (Hill et al, 1994, Hill et al, 2003. The pooled effect size for DAS28 were inconclusive (RoM = 0.96, 95%CI = 0.90 1.02, P = 0.16) (Figure 3).…”

“…One study (Hill et al, 2003) reported the number of patients whose DAS28 improved and those that got worse. Using this information, the risk ratio of DAS28 improvement was inconclusive (RR = 1.78, …”