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Arvidsson, Barbro
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Malm, K., Bremander, A., Arvidsson, B., Andersson, M. L., Bergman, S. & Larsson, I. (2016). The influence of lifestyle habits on quality of life in patients with established rheumatoid arthritis: A constant balancing between ideality and reality. International Journal of Qualitative Studies on Health and Well-being, 11, Article ID 30534.
Open this publication in new window or tab >>The influence of lifestyle habits on quality of life in patients with established rheumatoid arthritis: A constant balancing between ideality and reality
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2016 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 30534Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Rheumatoid arthritis (RA) is a chronic, inflammatory, and systemic disease with symptoms that limit activities and affect quality of life. RA is associated with an increased risk of developing comorbidities, some of which are also known to be associated with lifestyle habits such as physical activity, diet, smoking, and alcohol. There has been an augmented focus on the implementation and maintenance of healthy lifestyle habits even for patients with RA in the past decade, but little is known about the link between patients' experiences of lifestyle habits and quality of life. The aim of the study was thus to describe and explore how patients with established RA experience the influence of lifestyle habits on quality of life.

METHODS: The study had a descriptive and explorative design, based on qualitative content analysis. Strategic sampling was used in order to achieve variations in experiences. Twenty-two patients with RA (14 women and 8 men) from 30 to 84 years old, with a disease duration ranging from 8 to 23 years, were interviewed.

RESULTS: The analysis of the influence of lifestyle habits on quality of life resulted in the theme balancing between ideality and reality. Three categories emerged about how lifestyle habits influenced quality of life by limitations (including insufficiency and adaptation), self-regulation (including guilt and motivation), and companionship (including belonging and pleasure).

CONCLUSIONS: Quality of life for patients with established RA was influenced by the balance between ideality and reality in the lifestyle habits: physical activity, diet, smoking, and alcohol. This is important new knowledge for health professionals when discussing lifestyle habits with RA patients.

Place, publisher, year, edition, pages
Järfälla: Co-Action Publishing, 2016
Keywords
Lifestyle habits, qualitative content analysis, quality of life, rheumatoid arthritis
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-31943 (URN)10.3402/qhw.v11.30534 (DOI)000396164200001 ()27172513 (PubMedID)2-s2.0-84982682224 (Scopus ID)
Available from: 2016-09-07 Created: 2016-09-07 Last updated: 2018-03-22Bibliographically approved
Larsson, I., Fridlund, B., Arvidsson, B., Teleman, A., Svedberg, P. & Bergman, S. (2015). A nurse-led rheumatology clinic versus rheumatologist-led clinic in monitoring of patients with chronic inflammatory arthritis undergoing biological therapy: a cost comparison study in a randomised controlled trial. BMC Musculoskeletal Disorders, 16, Article ID 354.
Open this publication in new window or tab >>A nurse-led rheumatology clinic versus rheumatologist-led clinic in monitoring of patients with chronic inflammatory arthritis undergoing biological therapy: a cost comparison study in a randomised controlled trial
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2015 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 16, article id 354Article in journal (Refereed) Published
Abstract [en]

Background: Recommendations for rheumatology nursing management of chronic inflammatory arthritis (CIA) from European League Against Rheumatism (EULAR) states that nurses should take part in the monitoring patients’ disease and therapy in order to achieve cost savings. The aim of the study was to compare the costs of rheumatology care between a nurse-led rheumatology clinic (NLC), based on person-centred care (PCC), versus a rheumatologist-led clinic (RLC), in monitoring of patients with CIA undergoing biological therapy.

Methods: Patients with CIA undergoing biological therapy (n = 107) and a Disease Activity Score of 28 ≤ 3.2 were randomised to follow-up by either NLC or RLC. All patients met the rheumatologist at inclusion and after 12 months. In the intervention one of two annual monitoring visits in an RLC was replaced by a visit to an NLC. The primary outcome was total annual cost of rheumatology care.

Results: A total of 97 patients completed the RCT at the 12 month follow-up. Replacing one of the two annual rheumatologist monitoring visits by a nurse-led monitoring visit, resulted in no additional contacts to the rheumatology clinic, but rather a decrease in the use of resources and a reduction of costs. The total annual rheumatology care costs including fixed monitoring, variable monitoring, rehabilitation, specialist consultations, radiography, and pharmacological therapy, generated €14107.7 per patient in the NLC compared with €16274.9 in the RCL (p = 0.004), giving a €2167.2 (13 %) lower annual cost for the NLC.

Conclusions: Patients with CIA and low disease activity or in remission undergoing biological therapy can be monitored with a reduced resource use and at a lower annual cost by an NLC, based on PCC with no difference in clinical outcomes. This could free resources for more intensive monitoring of patients early in the disease or patients with high disease activity.

Trial registration: The trial is registered as a clinical trial at the ClinicalTrials.gov (NCT01071447). Registration date: October 8, 2009.

© 2015 Larsson et al.

Place, publisher, year, edition, pages
London: BioMed Central, 2015
Keywords
Biological therapy, Chronic inflammatory arthritis, Cost comparison, Person-centred care, Nurse-led
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-29853 (URN)10.1186/s12891-015-0817-6 (DOI)000364807600002 ()26573936 (PubMedID)2-s2.0-84946882419 (Scopus ID)
Note

This research was supported by the Swedish Association of Health Professionals, the Swedish Rheumatism Association, Region Halland and the Inger Bendix Foundation for Medical Research.

Available from: 2015-12-01 Created: 2015-12-01 Last updated: 2018-03-22Bibliographically approved
Malm, K., Arvidsson, B., Andersson, M., Bergman, S., Bremander, A. & Larsson, I. (2015). THU0628-HPR Lifestyle Habits Relates to Quality of Life in Patient with Longstanding Rheumatoid Arthritis. Paper presented at EULAR 2015, 16th Annual European Congress of Rheumatology – European League Against Rheumatism, Rome, Italy, 10-13 June, 2015. Annals of the Rheumatic Diseases, 74(Suppl. 2), 1318-1318
Open this publication in new window or tab >>THU0628-HPR Lifestyle Habits Relates to Quality of Life in Patient with Longstanding Rheumatoid Arthritis
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2015 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 74, no Suppl. 2, p. 1318-1318Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Fatigue, pain, stiffness, impaired muscle function and impaired physical function are some of the most pronounced symptoms in rheumatoid arthritis (RA) and these may be related to lifestyle habits such as physical activity, diet, smoking and alcohol.There is limited knowledge about how patient with longstanding RA understand their lifestyles habits in relation to their disease and quality of life.

Objectives: To describe experiences of how lifestyle habits relate to quality of life in patients with longstanding RA.

Methods: A qualitative study with a deductive content analysis design, including 17 patients from the Swedish BARFOT (Better Anti-Rheumatic FarmacoTherapy) cohort. BARFOT is a long time follow up study of early RA. Informants were strategically selected by gender (ten women and seven men), age (range 30-84 years), disease duration (8-23 years), function as measured by HAQ, and quality of life as measured by EQ5D. Semi-structured interviews focused on four lifestyle habits (main categories); Physical activity, Diet, Smoking, and Alcohol. The interviews were recorded, transcribed verbatim and coded into subcategories within each of the four main categories.

Results: In patients with longstanding RA quality of life was related to the four given main categories (lifestyle habits). Each main category included two to three subcategories; (1) Physical activity means barrier, opportunities and well-being, (2) Diet means shame, well-being and social relationship, (3) Smoking means reward and fear, and (4) Alcohol means ambivalence and social relationship.

Conclusions: In longstanding RA, lifestyle habits relates to quality of life through both positive and negative experiences. This has to be taken into account in clinical care for a better understanding of how patients conceive and adherer to advice on lifestyle.

References: Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet. 2010;376(9746):1094-108.

Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative health research. 2005;15(9):1277-88.

Place, publisher, year, edition, pages
London: BMJ Books, 2015
Keywords
lifestyle, rheumatoid arthritis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-28580 (URN)10.1136/annrheumdis-2015-eular.2988 (DOI)000215799104284 ()
Conference
EULAR 2015, 16th Annual European Congress of Rheumatology – European League Against Rheumatism, Rome, Italy, 10-13 June, 2015
Available from: 2015-06-16 Created: 2015-06-16 Last updated: 2018-03-22Bibliographically approved
Larsson, I., Fridlund, B., Arvidsson, B., Teleman, A. & Bergman, S. (2014). Biological therapy can be monitored more cost effectively by a nurse-led rheumatology clinic. Paper presented at EULAR (The European League Against Rheumatism) Annual European Congress of Rheumatology, Paris, France, 11-14 June, 2014. Annals of the Rheumatic Diseases, 72, Suppl. 3, 139-140
Open this publication in new window or tab >>Biological therapy can be monitored more cost effectively by a nurse-led rheumatology clinic
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2014 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 72, Suppl. 3, p. 139-140Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Patients with chronic inflammatory arthritis (CIA) treated with biological therapy are usually monitored by rheumatologists. Research shows that a nurse-led rheumatology clinic is safe and effective in monitoring biological therapy (1) and contributed added value in patients within rheumatology care, because the encounter with the nurse led to a sense of security, familiarity and participation (2).

Objectives: To compare the cost of monitoring biological therapy in a nurse-led rheumatology clinic with those of a rheumatologist-led clinic in patients with low disease activity or in remission.

Methods: Cost comparison was based on data from a 12 month randomised controlled trial (1). A total of 107 patients were randomly assigned to either a rheumatologist-led clinic or to a nurse-led rheumatology clinic. The purpose of the intervention was to replace one of two annual monitoring visits at the rheumatologist-led clinic (control group; n=54) by a visit to a nurse-led rheumatology clinic (intervention group; n=53), based on person-centred care. 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. All outpatient visits, team rehabilitation and all the telephone advice at the Rheumatology Clinic were registered for the patients who participated in the trial. Main outcome measures were direct costs related to rheumatology care during the 12 month follow-up period.

Results: After 12 months 97 patients completed the study. At the inclusion 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. There was no mean difference in changes in clinical outcome between the two groups (DAS28 -0.06; p=0.66). The total annual cost of team rehabilitation in rheumatology care, per patient monitored by the nurse-led rheumatology clinic was €580 compared with €1278 for monitoring by a rheumatologist-led clinic, translating in a €698 (55%) lower annual cost. The annual cost of just the outpatient rheumatology care provided by rheumatologist and rheumatology nurse, per patient was €457 for monitoring by the nurse-led rheumatology clinic compared with €598 for monitoring by a rheumatologist-led clinic, translating in a €141 (24%) lower annual cost.

Conclusions: Patients with stable CIA undergoing biological therapy can be monitored more cost effectively by a nurse-led rheumatology clinic compared to a rheumatologist-led clinic, with no difference in clinical outcome as measured by DAS28.

References

  1. Larsson et al. (2014). Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. J Adv Nurs, 70(1): 164-175.
  2. Larsson et al. (2012). Patients’ experiences of a nurse-led rheumatology clinic in Sweden – a qualitative study in patients undergoing biological therapy. Nurs Health Sci, 14(4): 501-507.
Place, publisher, year, edition, pages
London: BMJ Books, 2014
Keywords
Biological therapy, cost comparison, nurse-led rheumatology clinic, randomised controlled trial
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-27094 (URN)10.1136/annrheumdis-2014-eular.3805 (DOI)000346919800424 ()
Conference
EULAR (The European League Against Rheumatism) Annual European Congress of Rheumatology, Paris, France, 11-14 June, 2014
Available from: 2014-11-20 Created: 2014-11-20 Last updated: 2018-03-22Bibliographically approved
Arvidsson, S., Bergman, S., Arvidsson, B., Fridlund, B. & Tingström, P. (2013). Effects of a self-care promoting problem-based learning programme in people with rheumatic diseases: a randomized controlled study. Journal of Advanced Nursing, 69(7), 1500-1514
Open this publication in new window or tab >>Effects of a self-care promoting problem-based learning programme in people with rheumatic diseases: a randomized controlled study
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2013 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 7, p. 1500-1514Article in journal (Refereed) Published
Abstract [en]

Aim: To evaluate the effects of a self-care promoting problem-based learning programme for people with rheumatic diseases in terms of health-related quality of life, empowerment, and self-care ability.

Background: Individuals with rheumatoid arthritis express a great need for education and support in adapting to the disease, but the average qualities of studies about patient education interventions are not high. There is no evidence of long-term benefits of patient education.

Design: Randomized controlled trial.

Methods: A randomized controlled design was selected with test at baseline, 1-week and 6-month post-interventions after completed the 1-year programme. The tests consisted of validity and reliability tested instruments. The participants were randomly assigned in spring 2009 to either the experimental group (n = 54) or the control group (n = 148). The programme was running alongside the standard care the participants received at a rheumatology unit. Parametric and non-parametric tests were used in the analyses.

Results: The participants in the experimental group had statistically significant stronger empowerment after participation in the self-care promoting problem-based learning programme compared with the control group, at the 6-month post-intervention. Approximately, two-thirds of the participants in the experimental group stated that they had implemented lifestyle changes due to the programme.

Conclusion: The self-care promoting problem-based learning programme enabled people with rheumatic diseases to improve their empowerment compared with the control group. It is important to continue to develop problem-based learning in patient education to find the very best way to use this pedagogical method in rheumatology care. © 2012 Blackwell Publishing Ltd.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell, 2013
Keywords
empowerment, nursing, patient education, problem-based learning, rheumatic diseases, self-care
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-20653 (URN)10.1111/jan.12008 (DOI)000319829000006 ()22973890 (PubMedID)2-s2.0-84878623956 (Scopus ID)
Note

Funding: The Swedish Rheumatism Association, the Region Halland, the South Regional Health Care Committee, the Stig Thunes Foundation Fund for Health Care Research, the Norrbacka-Eugenia Foundation, the Association of Rheumatology Nurses in Sweden, and the Spenshult Hospital for Rheumatic Diseases.

Available from: 2013-01-10 Created: 2013-01-10 Last updated: 2018-03-22Bibliographically approved
Arvidsson, B. & Franke, A. (2013). Nurses' various ways of conceiving their learning process as doctoral students: A phenomenograhic study. Nurse Education in Practice, 13(1), 53-57
Open this publication in new window or tab >>Nurses' various ways of conceiving their learning process as doctoral students: A phenomenograhic study
2013 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 13, no 1, p. 53-57Article in journal (Refereed) Published
Abstract [en]

AIM: The aim was to describe variations in how doctoral students conceive their learning process to become researchers in the light of their professional background as nurses. BACKGROUND: Nursing research is an emerging discipline and the number of nurses who acquire a doctor's degree is increasing. METHOD: The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. RESULTS: Three different description categories emerged: (1) A learning process that provides a synthesis of different parts of the research process aimed at developing preparedness for action within the nursing profession. (2) A learning process where practical problems are integrated with and problematised in relation to scientific theories. (3) A learning process involving the transformation from nurse to researcher. CONCLUSIONS: The description categories revealed that the focus was on solving problems that occur in health care and synthesising them by means of research tools. Furthermore, the doctoral students explored different ways of understanding and developing their awareness of the nature of research. Focus was also on the nursing profession and practice and a shift towards the role of a researcher was evident.

Place, publisher, year, edition, pages
Kidlington: Churchill Livingstone, 2013
Keywords
Doctoral student, Learning process, Nurse, Phenomenography
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-19519 (URN)10.1016/j.nepr.2012.07.002 (DOI)000209270700010 ()22841368 (PubMedID)2-s2.0-84871678643 (Scopus ID)
Available from: 2012-09-07 Created: 2012-09-07 Last updated: 2018-03-22Bibliographically approved
Larsson, I., Fridlund, B., Arvidsson, B., Teleman, A. & Bergman, S. (2013). Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. Journal of Advanced Nursing, 70(1), 164-175
Open this publication in new window or tab >>Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy
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2013 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 1, p. 164-175Article in journal (Refereed) Published
Abstract [en]

AIM: To compare and evaluate the treatment outcomes of a nurse-led rheumatology clinic and a rheumatologist-led clinic in patients with low disease activity or in remission who are undergoing biological therapy.

BACKGROUND: Patients with chronic inflammatory arthritis treated with biological therapy are usually monitored by rheumatologists. Nurse-led rheumatology clinics have been proposed in patients with low disease activity or in remission.

DESIGN: Randomized controlled trial.

METHODS: A 12-month follow-up trial was conducted between October 2009 and August 2011, where 107 patients were randomized into two groups with a 6-month follow-up to a nurse-led rheumatology clinic based on person-centred care (intervention group; n = 53) or to a rheumatologist-led clinic (control group; n = 54). The hypothesis was that the nurse-led clinic outcomes would not be inferior to those obtained from a rheumatologist-led clinic at the 12-month follow-up. The primary outcome was disease activity measured by Disease Activity Score 28.

RESULTS: A total of 47 patients in the intervention group and 50 in the control group completed the 12-month trial. The trial revealed no statistically significant differences between groups in mean change of Disease Activity Score 28, Visual Analogue Scales for pain, the Health Assessment Questionnaire, satisfaction with or confidence in obtaining rheumatology care.

CONCLUSION: Patients with stable chronic inflammatory arthritis undergoing biological therapy could be monitored by a nurse-led rheumatology clinic without difference in outcome as measured by the Disease Activity Score 28. © 2013 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

Place, publisher, year, edition, pages
West Sussex: Wiley-Blackwell Publishing Inc., 2013
Keywords
biological therapy; intervention; nurse-led rheumatology clinic; person-centred care; randomized controlled trial
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:hh:diva-23509 (URN)10.1111/jan.12183 (DOI)000327900300017 ()23772698 (PubMedID)2-s2.0-84889655639 (Scopus ID)
Available from: 2013-09-09 Created: 2013-09-09 Last updated: 2018-03-22Bibliographically approved
Bergseth Bogsti, W., Solvik, E., Engelien, R. I., Larsen Moen, Ø., Sønsteby Nordhagen, S., Struksnes, S. & Arvidsson, B. (2013). Styrket veiledning i sykepleierutdanningens praksisperioder. Vård i Norden, 33(1), 56-60
Open this publication in new window or tab >>Styrket veiledning i sykepleierutdanningens praksisperioder
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2013 (Norwegian)In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 33, no 1, p. 56-60Article in journal (Refereed) Published
Abstract [en]

Background: A more complex and knowledge-based society has resulted in increasing specialization and greater demands on employees in the fields of practice. At Gjøvik University College, a new supervision model was tested for nursing students in practice. The main elements were: daily supervisors were given increased responsibility for assessing the students, while at the same time participating in three group counseling meetings. A portfolio contained the student’s work requirements. A weekly reflection hour was formalized. Purpose: The purpose was to elucidate how the supervision model influenced the student’s learning situation. Method: The SVIP model was evaluated by the use of focus group interviews. The data were analyzed using qualitative content analysis. Findings: Three categories: structure, inclusion and self-confidence describe the students’ need for clear guidelines and objectives, as well as their need to be included and to be seen. Conclusion: Various aspects of clinical practice, including daily supervision are important for student learning. Counseling meetings where the supervisor role is recognized and developed through the tutor, and daily supervisor sharing of experiences and knowledge, should permeate the cooperation.

Place, publisher, year, edition, pages
Oslo: Sykepleiernes Samarbeid i Norden, 2013
Keywords
cooperation, nursing education, primary health care, qualitative study, supervision
National Category
Pedagogical Work
Identifiers
urn:nbn:se:hh:diva-21851 (URN)
Available from: 2013-04-30 Created: 2013-04-30 Last updated: 2018-03-22Bibliographically approved
Larsson, I., Fridlund, B., Arvidsson, B. & Bergman, S. (2012). Biological therapy could be monitored by a rheumatology nurse-led clinic without any differences in outcome – a randomised controlled study. In: : . Paper presented at The first World Congress on Debates & Consensus in Bone, Muscle and Joint Diseases (BMJD), The Academy for Clinical Debates & Controversies in Medicine, Barcelona, Spain, 19-22 January, 2012.
Open this publication in new window or tab >>Biological therapy could be monitored by a rheumatology nurse-led clinic without any differences in outcome – a randomised controlled study
2012 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: Patients with rheumatic diseases treated with biological therapy are usually followed up by rheumatologists. Nurse-led rheumatology clinics have been proposed for patients who are in low disease activity or 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 rheumatology nurse (intervention group; n=53) or to a rheumatologist (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. After 12 months 97 patients completed the study. Main outcome was disease activity measured by DAS28.

Results: Patients had mean age of 55.4 years and disease duration of 16.7 years. DAS28 was 2.1. At inclusion there were no significant differences in DAS28 between the groups. There were no differences (p=0.67) in change of DAS28 between the intervention group (0.14) or control group (0.20) from inclusion to 12 months.

Conclusions: In patients with low disease activity biological therapy could be monitored by a nurse-led rheumatology clinic without any differences in outcome as measured by DAS28.

Keywords
Biological therapy, outcome, nurse-led rheumatology clinic
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-21461 (URN)
Conference
The first World Congress on Debates & Consensus in Bone, Muscle and Joint Diseases (BMJD), The Academy for Clinical Debates & Controversies in Medicine, Barcelona, Spain, 19-22 January, 2012
Available from: 2013-02-12 Created: 2013-02-12 Last updated: 2018-03-22Bibliographically approved
Larsson, I., Arvidsson, B., Fridlund, B., Teleman, A. & Bergman, S. (2012). Nurse-led rheumatology clinic versus rheumatologist clinic in monitoring of biological therapy– a randomised controlled study. Paper presented at Annual European Congress of Rheumatology EULAR 2012, Berlin, Tyskland, 6-9 June. Annals of the Rheumatic Diseases, 71(Suppl. 3), 121-121
Open this publication in new window or tab >>Nurse-led rheumatology clinic versus rheumatologist clinic in monitoring of biological therapy– a randomised controlled study
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2012 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, Vol. 71, no Suppl. 3, p. 121-121Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

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

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2012
Keywords
Nurse-led Rheumatology, Biological therapy, Person-centrerd care
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-21459 (URN)000208898500400 ()
Conference
Annual European Congress of Rheumatology EULAR 2012, Berlin, Tyskland, 6-9 June
Available from: 2013-02-12 Created: 2013-02-12 Last updated: 2018-03-22Bibliographically approved
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