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Nurse-Led Consultation for Patients With Rheumatoid Arthritis at Low Disease Activity: A Randomized Noninferiority
Suet-Kei Kwok1, Lai-Man Tang1, Hoi-Lun Tsang1
1Queen Mary Hospital, Hong Kong, China.
Arthritis Care & Research
|May 11, 2021
Summary
Nurse-led consultations are as effective as rheumatologist visits for managing stable rheumatoid arthritis (RA) in Hong Kong. Patients maintained low disease activity (LDA) and reported higher satisfaction with nurse-led care.
Area of Science:
- Rheumatology
- Nursing Care
- Clinical Trials
Background:
- Rheumatoid arthritis (RA) management requires ongoing monitoring.
- Nurse-led consultations offer a potential alternative for patient follow-up.
- Evaluating non-inferiority of nurse-led care is crucial for optimizing RA management.
Purpose of the Study:
- To assess the effectiveness of nurse-led consultations versus traditional rheumatologist follow-up for stable RA patients.
- To determine if nurse-led care maintains low disease activity (LDA) in RA patients over two years.
Main Methods:
- A single-center, randomized, open-label, noninferiority trial was conducted.
- 280 patients with stable RA and LDA were randomized to nurse-led or rheumatologist care for 2 years.
- Primary endpoint: proportion of patients remaining in LDA; secondary endpoints included disease remission and various patient-reported outcomes.
Main Results:
- 92.1% of patients in nurse-led group and 91.4% in rheumatologist group remained in LDA.
- Nurse-led consultations were non-inferior to rheumatologist follow-up, meeting the primary endpoint.
- Patients reported higher satisfaction with nurse-led consultations, despite some differences in DAS28-CRP scores.
Conclusions:
- Nurse-led consultations are a viable and effective alternative to rheumatologist follow-up for stable RA patients.
- This model of care can maintain disease control and improve patient satisfaction.
- Findings support the integration of nurse-led services in RA management programs.
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