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A nurse-led rheumat...
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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- Larsson, Ingrid, 1968- (author)
- Högskolan i Halmstad,Hälsofrämjande processer,Spenshult Research and Development Centre, Halmstad, Sweden
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- Fridlund, Bengt (author)
- Jönköping University,HHJ. ADULT,School of Health and Welfare, Jönköping University, Jönköping, Sweden
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- Arvidsson, Barbro, 1945- (author)
- Högskolan i Halmstad,Centrum för forskning om välfärd, hälsa och idrott (CVHI)
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- Teleman, A. (author)
- Capio Movement Hospital, Halmstad, Sweden
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- Svedberg, Petra, 1973- (author)
- Högskolan i Halmstad,Hälsofrämjande processer
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- Bergman, Stefan (author)
- Högskolan i Halmstad,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Spenshult Research and Development Centre, Halmstad, Sweden & University of Gothenburg, Gothenburg, Sweden,Hälsofrämjande processer
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(creator_code:org_t)
- 2015-11-16
- 2015
- English.
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In: Bmc Musculoskeletal Disorders. - London : Springer Science and Business Media LLC. - 1471-2474. ; 16:354
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https://hj.diva-port... (primary) (Raw object)
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https://doi.org/10.1...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
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- 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 (sic)14107.7 per patient in the NLC compared with (sic)16274.9 in the RCL (p = 0.004), giving a (sic)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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Arbetsterapi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Occupational Therapy (hsv//eng)
Keyword
- Biological therapy
- Chronic inflammatory arthritis
- Cost comparison
- Person-centred care
- Nurse-led
- person-centered care
- modifying antirheumatic drugs
- eular
- recommendations
- psoriatic-arthritis
- tight control
- shared care
- 2013
- update
- follow-up
- management
- consultations
- Orthopedics
- Rheumatology
- Biological therapy
Publication and Content Type
- ref (subject category)
- art (subject category)
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