Patients attending clinical nurse specialist clinics do not get inferior treatment to that offered by consultant rheumatologists, the results of a major new Arthritis Research UK clinical trial have revealed. The results of the multi-centre trial at the University of Leeds showed that there may be some clinical benefit for people with rheumatoid arthritis managed in clinics run by rheumatology clinical specialist nurses, especially with respect to their disease activity, pain control, physical function and general satisfaction with their care. Rheumatoid arthritis is a chronic inflammatory disease, which if untreated may lead to severe disability or death. However, the management of the disease has changed significantly over the past ten years due to better understanding of the disease process, an emphasis on early diagnosis, intensive treatment and the use of more efficacious drug therapies.

  • The nation-wide trial compared the outcomes of 180 people with rheumatoid arthritis in 10 out-patient clinics around the UK, half run by clinical nurse specialists, and the other by rheumatologists.
  • In both groups the nurse or doctor took a patient history, carried out a physical examination, discussed pain control, change of drugs or dose (including steroid injections) and offered patient education and psychosocial support.
  • The nurse-led clinics appointment times were on average longer compared to the consultants’ (20 vs 15 minutes).
  • The results of the study 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 admissions or visits to A and E.

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