Specialist Nurses for RA

You’ll likely seek out a doctor’s insight if you suffer from rheumatoid arthritis (RA), but a new study suggests that it’s a nurse who can make all the difference in managing your disease. Research from the University of Leeds in the U.K. shows that care from clinical nurse specialists is just as good—perhaps even better—than similar treatment offered by consultant rheumatologists.

"The results of this study show that clinics run by rheumatology clinical nurse specialists can manage many people with rheumatoid arthritis without any reduction in the quality of care and treatment," said Dr. Mwidimi Ndosi of Leeds Institute of Rheumatic and Musculoskeletal Medicine in a press release.

The findings, published in Annals of the Rheumatic Diseases, could pave the way for significant changes in the way we think about not only the treatment of RA but also about the role of nurses in health care.

"There will obviously always be a place for specialist medical input at certain times in the patient journey, but this study shows the importance of specialist rheumatology team work and is a future model of care which requires serious consideration for widespread implementation within the NHS [National Health Service],” said Professor Alan Silman, medical director of Arthritis Research U.K.

Patients in the nationwide randomized controlled trial were separated into two groups over a 12-month period. One group was assigned to nurse-led care, while the other was given rheumatologist-led care. Both groups received routine treatment and were assessed periodically.

Nurse-led care was more cost-effective with respect to cost of care and disease activity change, a measurement used to evaluate the progression of RA. The most striking find in this study, however, was that those in the nursing group saw more improvement in disease activity than those in the doctor-led group. Researchers also determined that the nurses were just as competent as the rheumatologists at all individual follow-up time points and at the endpoint of the study.

Why Is This Important?

This study gives strong support to the idea that clinical nurse specialists can provide quality care at the same level as some specialist doctors.

"The development of the role of clinical nurse specialist in rheumatology has resulted in great improvements in rheumatology service, providing a high quality, accessible, and person-centered care to people with rheumatoid arthritis," said Dr. Jackie Hill, formerly of the Institute of Rheumatic and Musculoskeletal Medicine.

The study also lends credence to the importance of nurses in comprehensive healthcare. Like doctors, they have excellent qualifications, but they may also bring an extra level of personal care and comfort to those suffering from a disease as painful as RA.

How you choose to manage your RA is a personal decision, but know that you have many options available to you in addition to rheumatologists.

"Rheumatoid arthritis is, despite modern treatment, a chronic condition requiring long-term expert professional care to help patients manage their symptoms and control disease,” Sliman explained in a press release. "This care necessarily involves many different healthcare professionals.”

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