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Specialist nurses surpass docs in delivering arthritis care

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Specialist nurses are at least as good as doctors at managing rheumatoid arthritis patients, according to latest UK study results.

Research led by Leeds University showed there may be clinical benefits for patients managed in clinics run by rheumatology clinical nurse specialists, especially with respect to disease activity, pain control, physical function and general satisfaction with care.

The nationwide trial compared the outcomes of 180 people with rheumatoid arthritis in 10 out-patient clinics, half run by nurses and half by rheumatologists.

All of the patients gave a background of their medical problems, underwent a physical examination, were given a talk about pain control and change of drugs or dose, and were offered education and psychosocial support. The nurses typically spent 20 minutes with their patients, five minutes longer than the consultants.

The results, published in the Annals of the Rheumatic Diseases, found that although the nurses made fewer changes to a patient’s medication and ordered fewer x-rays and steroid injections, their patients had greater improvement in disease activity than those under rheumatologists’ care.

Nurses also provided patient education and psychosocial support more frequently than rheumatologists, and their patients also had fewer unplanned hospital visits.

Lead researcher Dr Jackie Hill said: “The development of the role of clinical nurse specialist in rheumatology has resulted in great improvements in rheumatology service, providing high quality, accessible and person-centred care.

“The results of this research are encouraging, demonstrating that this model of care is effective, safe, and associated with more patient satisfaction.”

Professor Alan Silman, medical director of Arthritis Research UK, added:  “Why this study is so important is that it shows that specialist trained nurses can improve outcome, enhance the patient experience and reduce costs when compared to conventional doctor-led services.”

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Readers' comments (1)

  • The research is an excellent support for the CNS role. Lets hope that those Rheumatologists we do not appreciate the role of the CNS will take note.
    I work with 2 Rheumatologists here in New Zealand who support my work whole heartedly and have faith in the difference i can make to my patients life.
    I will pass it on to my collegues, who are not supported, in the hope it will allowthem to fight to be acknowleged as experts in their role

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