Evaluation of the impact of nursing clinics in the rheumatology services

• Published in: Rheumatology international Vol. 36; no. 9; pp. 1309 - 1317
• Main Authors: Muñoz-Fernández, Santiago, Aguilar, Ma Dolores, Rodríguez, Amparo, Almodóvar, Raquel, Cano-García, Laura, Gracia, Luís Antonio, Román-Ivorra, José A., Rodríguez, J. Ramón, Navío, Teresa, Lázaro, Pablo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2016; Springer Nature B.V
• Subjects: Aged; Female; Health Services Research; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nurses; Prospective Studies; Quality of Life; Rheumatic Diseases - nursing; Rheumatology; Treatment Outcome; Quality indicators; Nursing; Rheumatoid arthritis; Ankylosing spondylitis; Health services research
• ISSN: 0172-8172; 1437-160X
• DOI: 10.1007/s00296-016-3518-z

Nursing clinics in rheumatology (NCRs) are organisational care models that provide care centred within the scope of a nurse’s abilities. To analyse the impact of NCR in the rheumatology services, national multicenter observational prospective cohort studied 1-year follow-up, comparing patients attending rheumatology services with and without NCR. NCR was defined by the presence of: (1) office itself; (2) at least one dedicated nurse; and (3) its own appointment schedule. Variables included were (baseline, 6 and 12 months): (a) test to evaluate clinical activity of the disease, research and training, infrastructure of unit and resources of NCR and (b) tests to evaluate socio-demographics, work productivity (WPAI), use of services and treatments and quality of life. A total of 393 rheumatoid arthritis and ankylosing spondylitis patients were included: 181 NCR and 212 not NCR, corresponding to 39 units, 21 with NCR and 18 without NCR (age 53 + 11.8 vs 56 + 13.5 years). Statistically significant differences were found in patients attended in sites without NCR, at some of the visits (baseline, 6 or 12 months), for the following parameters: higher CRP level (5.9 mg/l ± 8.3 vs 4.8 mg/l ± 7.8; p  < 0.005), global disease evaluation by the patient (3.6 ± 2.3 vs 3.1 ± 2.4), physician (2.9 ± 2.1 vs 2.3 ± 2.1; p  < 0.05), use of primary care consultations (2.7 ± 5.4 vs 1.4 ± 2.3; p  < 0.001) and worse work productivity. The presence of NCR in the rheumatology services contributes to improve some clinical outcomes, a lower frequency of primary care consultations and better work productivity of patients with rheumatic diseases.