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首页> 外文期刊>BMC Musculoskeletal Disorders >A nurse-led rheumatology clinic versus rheumatologist-led clinic in monitoring of patients with chronic inflammatory arthritis undergoing biological therapy: a cost comparison study in a randomised controlled trial
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A nurse-led rheumatology clinic versus rheumatologist-led clinic in monitoring of patients with chronic inflammatory arthritis undergoing biological therapy: a cost comparison study in a randomised controlled trial

机译：一种护士LED风湿病学诊所与风湿病学 - LED诊所，监测慢性炎症性关节炎患者进行生物治疗：随机对照试验中的成本比较研究

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Recommendations for rheumatology nursing management of chronic inflammatory arthritis (CIA) from European League Against Rheumatism (EULAR) states that nurses should take part in the monitoring patients’ disease and therapy in order to achieve cost savings. The aim of the study was to compare the costs of rheumatology care between a nurse-led rheumatology clinic (NLC), based on person-centred care (PCC), versus a rheumatologist-led clinic (RLC), in monitoring of patients with CIA undergoing biological therapy. Patients with CIA undergoing biological therapy (n?=?107) and a Disease Activity Score of 28?≤?3.2 were randomised to follow-up by either NLC or RLC. All patients met the rheumatologist at inclusion and after 12?months. In the intervention one of two annual monitoring visits in an RLC was replaced by a visit to an NLC. The primary outcome was total annual cost of rheumatology care. A total of 97 patients completed the RCT at the 12?month follow-up. Replacing one of the two annual rheumatologist monitoring visits by a nurse-led monitoring visit, resulted in no additional contacts to the rheumatology clinic, but rather a decrease in the use of resources and a reduction of costs. The total annual rheumatology care costs including fixed monitoring, variable monitoring, rehabilitation, specialist consultations, radiography, and pharmacological therapy, generated €14107.7 per patient in the NLC compared with €16274.9 in the RCL (p?=?0.004), giving a €2167.2 (13?%) lower annual cost for the NLC. Patients with CIA and low disease activity or in remission undergoing biological therapy can be monitored with a reduced resource use and at a lower annual cost by an NLC, based on PCC with no difference in clinical outcomes. This could free resources for more intensive monitoring of patients early in the disease or patients with high disease activity. The trial is registered as a clinical trial at the ClinicalTrials.gov ( NCT01071447 ). Registration date:?October 8, 2009.
机译：从欧洲联盟对风湿病（欧洲）的慢性炎症性关节炎（CIA）的风湿病学护理管理建议称，护士应参与监测患者的疾病和治疗，以便储蓄成本。该研究的目的是将病毒学关怀的成本进行比较，基于人以人为本的护理（PCC），与风湿病学家LED诊所（RLC）进行监测，以监测CIA患者正在进行生物疗法。 CIA患者接受生物疗法（N？= 107），疾病活动得分为28Ω·3.2，通过NLC或RLC随访。所有患者均在包容性和12个月后遇到风湿病学者。在讨论中，RLC中的两个年度监测访问中的一个是访问NLC的。主要结果是风湿病学关怀的总年度成本。共有97名患者在12个月后完成了RCT。通过护士LED监测访问取代两年的每年风湿病学家监测之一，导致风湿病学诊所没有额外的联系，而是降低资源的使用和降低成本。每年的风湿病学保证费用包括固定监测，可变监测，康复，专业咨询，射线照相和药理治疗，在NLC中产生了每位患者的14107.7欧元，而RCL中的€16274.9（p？= 0.004），给予2167.2（13？％）为NLC的年度成本降低。 CIA患者和低疾病活动或缓解生物治疗的患者可以通过降低的资源使用和NLC的年度降低，基于PCC，临床结果没有差异。这可以免费提供资源，以便在疾病早期的患者或疾病活动患者的更密集监测。该试验在Clinicaltrials.gov（NCT01071447）注册为临床试验。注册日期：？2009年10月8日。

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