Living with chronic inflammatory arthritis (CIA), such as rheumatoid arthritis (RA) or spondyloarthritis (SpA), affects not only patients’ physical functioning but also emotional, psychological, and social aspects that have a global effect on their life situation as a whole1. The multidisciplinary team is important for the rheumatology care of patients with CIA, which should be delivered with an awareness of the patients’ whole life situation. The team should enable these patients to care for themselves and retain or regain optimum independence. The various professional categories in the team have distinct roles but collaborate to focus on the patients’ resources and needs2. Recommendations for rheumatology nursing management of CIA from the European League Against Rheumatism state that rheumatology nurses should participate in comprehensive disease management to control disease activity, as well as in identifying, assessing, and addressing psychosocial issues. This work is a valuable complement to the medical care and helps lower healthcare costs. For patients to achieve a greater sense of control, self-efficacy and empowerment, the nurse should meet the patient’s expressed needs and promote self-management skills3.
Rheumatology research has completely changed the therapeutic arena over the past 2 decades, generating the development of the biological disease-modifying antirheumatic drugs (bDMARD) for a greater number of indications4. Despite this advance, research on nurse-led rheumatology care (NLC) has predominantly focused on patients with RA and conventional DMARD. A systematic review, including 4 randomized controlled trials (RCT) from 1994 to 2006, revealed in a metaanalysis (n = 431) that NLC compared to rheumatologist-led care (RLC) added value by improving patients’ perceived quality of life and knowledge, and lessening fatigue. While patient-reported outcomes such as functional status, satisfaction, pain, stiffness, and coping with arthritis favored NLC, there was insufficient evidence to draw conclusions5.
Subsequent …
Address correspondence to I. Larsson, School of Health and Welfare, Halmstad University Box 823, S-30118 Halmstad, Sweden. E-mail: Ingrid.larsson{at}hh.se