Screening for and management of comorbidities after a nurse-led program: results of a 3-year longitudinal study in 769 established rheumatoid arthritis patients

• DOI: 10.1136/rmdopen-2019-000914
• Publication Date: 2019-06-14T14:14:03Z
• Authors: Laure Gossec; Martin Soubrier; Frantz Foissac; Anna Molto; Pascal Richette; Catherine Beauvais; Adeline Ruyssen-W...; Aleth Perdriger; Isabelle Chary-Va...; Gael Mouterde; Emanuelle Dernis; Liana Euller-Ziegler; René-Marc Flipo; Mélanie Gilson; Sandrine Guis; Xavier Mariette; Sophie Pouplin; Thierry Marhadour; Thierry Schaeverbeke; Christelle Sordet; Françoise Fayet; Maxime Dougados
• Keywords: rheumatoid arthritis; Male; [SDV]Life Sciences [q-bio]; 610; Rheumatoid Arthritis; Comorbidity; Nurses, Community Health; Arthritis, Rheumatoid; 03 medical and health sciences; 0302 clinical medicine; nursing; Patient Education as Topic; cardiovascular disease; Neoplasms; 616; Humans; Mass Screening; Longitudinal Studies; Prospective Studies; Aged; multidisciplinary team care; Middle Aged; vaccination; 3. Good health; [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system; Cardiovascular Diseases; Osteoporosis; Female; Delivery of Health Care

Background/purpose Cardiovascular (CV) risk, cancer, infections and osteoporosis should be screened for in rheumatoid arthritis (RA). The objective was to assess 3-year effects of a nurse visit comorbidity counselling. Methods This an open long-term (3 years) extension the Comorbidities Education Rheumatoid Arthritis 6-month randomised controlled trial which patients with definite, stable RA were visiting Comorbidity status assessed nurses provided advice on screening management, at baseline 3 years later. A score developed quantify management: 0–100, where lower scores indicate better management. compared between assessment using Wilcoxon test paired data. Results Of 970 recruited patients, 776 (80%) followed-up 2–4 769 (79%) had available data comorbidities both time points: mean (±SD) age 58 (±11) disease duration 14 (±10) years; 614 women, Disease Activity Score 28 3.0±1.3, 538 (70%) receiving biologic. At baseline, 36.6 (±19.9) it improved 24.3 (±17.8) (p<0.0001), thus relative improvement 33% (improvement 12 points). CV risk screening, vaccination bone densitometry performance most. Conclusions suboptimal but notably over years, after nurse-led programme aiming checking systematically giving patient advice. efficacy pleads favour interventions address RA. Trial registration number NCT01315652