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Treatment Outcomes From a Nurse-Led Rheumatology Clinic in Monitoring of anti-TNF Therapy – a Randomised Controlled Trial
Jönköping University, Jönköping, Sweden.ORCID iD: 0000-0002-4341-660X
Jönköping University, Jönköping, Sweden. (Avdelning för Hälsa och vårdvetenskap)
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
Spenshult Hospital, R&D Center, Spenshult Hospital, Oskarström, Sweden.
2012 (English)In: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 64, no 10, p. S667-S667, article id 1559Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Patients with chronic inflammatory arthritis (CIA) treated with anti-TNF therapy are usually followed up by rheumatologists. Nurse-led rheumatology clinics have been proposed for patients with low disease activity or in remission. The purpose of this trial was to compare treatment outcomes from a nurse-led rheumatology clinic and a rheumatologist clinic for patients undergoing anti-TNF therapy with low disease activity or in remission.

Methods: A randomized controlled trial (RCT) with a 12-month follow-up was conducted with 107 patients randomised into two groups with a 6-month follow up to a nurse-led rheumatology clinic based on a person-centred care (intervention group; n=53) or to a rheumatologist-led clinic (control group; n=54). The intention of the interventional trial was to replace one of the two annual rheumatologist monitoring visits by a nurse-led rheumatology monitoring visit for patients undergoing anti-TNF therapy. Inclusion criteria were patients undergoing anti-TNF therapy and Disease Activity Score 28 (DAS28) ≤3.2. The hypothesis was that the outcomes from nurse-led clinic will not be inferior to those obtained by rheumatologist-led clinic at 12-month follow-up. Primary outcome was disease activity measured by DAS28.

Results: After 12 months 47 patients in the intervention group and 50 patients in the control group completed the trial and there were no differences (p=0.66) in mean change of DAS28 between the intervention or control group. There were no differences (p>0.05) in mean change in Visual Analogue Scales (VAS) for pain, Health Assessment Questionnaire (HAQ), satisfaction or security with the rheumatology care  between the two groups, see table.

Conclusion: In monitoring of anti-TNF therapy treatment outcomes for patients at a nurse-led rheumatology clinic are not inferior to those obtained by rheumatologist-led clinic at 12-month follow-up. The follow-up care of anti-TNF therapy may advantageously be performed by a nurse-led clinic based on a person-centred care. The results from this trial demonstrated that patients with CIA undergoing anti-TNF therapy, with low disease activity or in remission, could be monitored by a nurse-led rheumatology clinic without any differences in outcome as measured by DAS28.

Place, publisher, year, edition, pages
Hoboken, NJ: John Wiley & Sons, 2012. Vol. 64, no 10, p. S667-S667, article id 1559
Keywords [en]
nurse-led rheumatology clinic, biological therapy, anti-TNF therapy and rheumatoid arthritis, treatment
National Category
Nursing
Identifiers
URN: urn:nbn:se:hh:diva-21456DOI: 10.1002/art.37735ISI: 000309748303280OAI: oai:DiVA.org:hh-21456DiVA, id: diva2:604716
Conference
American College of Rheumatology, ACR 2012, Washington, D.C., USA, 10-14 November, 2012
Available from: 2013-02-12 Created: 2013-02-12 Last updated: 2018-03-22Bibliographically approved

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Larsson, IngridFridlund, BengtArvidsson, BarbroBergman, Stefan

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