The outcome and cost-effectiveness of nurse-led care in people with rheumatoid arthritis: a multicentre randomised controlled trial

摘要

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterised by joint swelling, joint tenderness and destruction of synovial joints, leading to severe disability and premature mortality.1 Approximately two million people live with RA in Europe where the average prevalence is 0.49%.2 RA has a negative impact on individuals' physical, social and psychological functioning, and the resulting disability contributes significantly to the burden of disease in RA.The primary goal of treatment is to suppress disease activity, thus preventing structural damage and optimising function and social participation.The management of RA has seen significant changes over the past decade due to increased understanding of the disease processes, diagnostic techniques and the development of more efficacious therapies and assessments. The goal of treatment now includes remission, which was once unobtainable at the onset of RA.This change in the emphasis of treatment has resulted in better health-related outcomes for people with RA, but it has also meant an increased need for monitoring, more coordinated multidiscipiinary teams and the development of nurse-led care (NLC).