Specialist nurses manage rheumatoid arthritis as well as doctors

People with rheumatoid arthritis who are treated in clinics run by clinical nurse specialists receive treatment that is just as good as that offered by consultant rheumatologists, says a study published in the Annals of the Rheumatic Diseases.

Experts spoke to 180 people with rheumatoid arthritis from 10 different outpatient clinics around the UK. Five were run by rheumatologists and five by clinical nurse specialists.

Appointment times at the nurse-led clinics tended to be longer compared to the consultants’ (20 minutes versus 15 minutes) but both groups reported that the doctor or nurse recorded their patient history, carried out a physical examination, discussed pain control, change of drugs or dose and offered education and support.

Nurses made less changes to medication and ordered fewer steroid injections and X-rays but their patients improved more in terms of disease activity than those under the care of rheumatologists and had fewer unplanned trips to hospital. Nurses provided education and support more often than rheumatologists and their clinics were cheaper to run.

“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-centred care to people with rheumatoid arthritis,” says Dr Jackie Hill who was involved in the study. “The results of this research are encouraging, demonstrating that this model of care is effective, safe, and associated with more patient satisfaction. At a time when deficiencies have come to light in some areas of the NHS, it’s good to know that in rheumatology there are high levels of satisfaction with the care we provide.”