Clinical effectiveness and cost‐effectiveness of nurse‐led care in Chinese patients with rheumatoid arthritis: A randomized trial comparing with rheumatologist‐led care. Issue 1 (26th October 2017)

• Record Type: Journal Article
• Authors: Wang, Junru; Zou, Xiulan; Cong, Ling; Liu, Huina
• Is Part Of: International journal of nursing practice. Volume 24:Issue 1(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-10-26
• Subjects: disease activity -- nurse‐led care -- rheumatoid arthritis -- cost‐effectiveness -- rheumatologist‐led care -- rheumatology; Nursing -- Periodicals; Nursing -- Practice -- Periodicals; 610.73092
• DOI: 10.1111/ijn.12605
• Languages: English
• ISSNs: 1322-7114

Abstract

Abstract: Background and aim: The concept of nurse‐led care (NLC) was not familiar in China. This study was designed to evaluate the clinical effectiveness and cost‐effectiveness of NLC versus rheumatologist‐led care (RLC) in Chinese patients with rheumatoid arthritis (RA). Methods: Patients of either gender (aged ≥18 years) with RA were enrolled at Wenhai Central Hospital, China (January 2015 to December 2015). The participants were then randomized to NLC or RLC. Outcomes of both the groups were compared in terms of effectiveness by measuring the Disease Activity Score 28, visual analogue scores pertaining to pain and fatigue, and duration of morning stiffness. Costs associated with resource use for RA were assessed and compared between both groups. Results: A total of 214 RA patients in 2 groups (n = 107 in each group) were enrolled and analysed. Improvements in clinical outcomes (disease activity, pain, fatigue, and morning stiffness) over 12 months were significantly greater in the NLC group compared to RLC ( P < 0.001). Overall, costs associated with resource use were higher in the RLC group compared to the NLC group ( P < 0.05). Conclusions: Our preliminary finding suggested that RA patients managed by NLC compared to RLC may have better clinical outcomes and more cost‐effective care in China. SUMMARY STATEMENT: What is already known about this topic? A nurse‐led care (NLC) model of rheumatology care has already been established in Canada, United States, Australia, and Europe (United Kingdom) in rheumatology services for the management of chronic disorders and has been found effective with greater patient satisfaction. What this paper adds? The concept of nurse‐led care was not familiar in China, and there was no study evaluating the clinical effectiveness and costs associated with rheumatoid arthritis resource use after NLC versus rheumatologist‐led care (RLC) among Chinese patients with rheumatoid arthritis. This preliminary randomized study evaluated the clinical effectiveness and cost‐effectiveness of NLC versus RLC in Chinese patients with rheumatoid arthritis. Preliminary findings indicated that rheumatoid arthritis patients managed by NLC had better clinical outcomes in terms of improvements in disease symptoms compared to RLC. Nurse‐led care was found to be a cost effective approach in managing Chinese patients with rheumatoid arthritis. The implications of this paper: This study serves as a basis for conducting an adequately powered multicentric randomized clinical study to establish the concept of NLC in Chinese patients with rheumatoid arthritis.