Patients' Experiences of Nurse‐Led Screening for Cardiovascular Risk in Rheumatoid Arthritis

Frølund, Jannie Christina; Primdahl, Jette

doi:10.1002/msc.1104

Cited by 16 publications

(33 citation statements)

References 37 publications

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“…Our results may not be generalizable to other practices. However, our findings are consistent with prior studies with much smaller numbers of subjects (11,12). Many patients were not reachable, leading to potential response bias, although the majority of patients who were reachable agreed to participate.…”

Section: Discussionsupporting

confidence: 93%

“…Few studies reported on patient awareness of the higher CV risk associated with the diagnosis of RA (9,11‐13). Some reports were based on extensive in‐person interviews of a few patient volunteers (11,12). Similar to the results of our study, knowledge of RA as a CV risk factor was reportedly low (less than 50%) in patients and decreased with increasing age (13).…”

Section: Discussionmentioning

confidence: 99%

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Patient Perception of Cardiovascular Risk in Rheumatoid Arthritis

Banerjee

George

Singh

et al. 2020

ACR Open Rheumatology

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Objective. Patients with rheumatoid arthritis (RA) have higher incidence of cardiovascular diseases (CVDs) compared with age-and sex-matched controls. The objective of our study was to measure the knowledge of patients with RA about the association between their disease and cardiovascular (CV) risk and to measure the frequency of counseling by physicians based on patient report.Methods. A telephone survey was conducted among patients with RA enrolled in the Consortium of Rheumatology Researchers of North America RA registry to collect data on medical and social history and on knowledge about CVD risk in RA and how they learned about that risk. Multivariable logistic regression models were performed to determine the factors associated with patients' knowledge and factors influencing likelihood of physician counseling. The odds ratios (ORs) represent adjusted multivariable results.Results. Of 185 patients with RA included in the study, 87 patients (47%) were aware that RA was a CV risk factor. Older age (OR 0.6; 95% confidence interval [CI] 0.4-0.8 per decade) and smoking (OR 0.4; 95% CI 0.1-0.9) were associated with low awareness, whereas disease duration of more than 10 years (OR 5.2; 95% CI 2.2-12.1) was positively associated with patient knowledge. Counseling by physicians, mostly rheumatologists, on CV risk in RA was reported by 47 patients (25%). Disease duration of more than 10 years (OR 3.9; 95% CI 1.2-13.1) was positively associated with patient-reported counseling. Patients with hypertension were less likely to report counseling (OR 0.4; 95% CI 0.2-0.9).Conclusion. Our study demonstrated low patient awareness of CV risk with RA and low rates of patient-reported counseling by physicians. This is an unmet need in clinical practice, which may be overcome by multimodal approaches such as developing websites, organizing symposiums, and involving health care providers at various levels.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Patient Perception of Cardiovascular Risk in Rheumatoid Arthritis

Banerjee

George

Singh

et al. 2020

ACR Open Rheumatology

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“…Additional evidence from various studies supports the distinct role of the nurse for patients with RA. Nurses have an established role in joint examination, management of comorbidity screening, strengthening of adherence to vaccination regimens, early detection of arthritis, interpretation of laboratory results, and initiation and adjustment of the pharmacological treatment 11 60–68…”

Section: Resultsmentioning

confidence: 99%

“…One RCT examined depression and found non-inferiority of nurse-led care compared with rheumatologist-led care 16. Qualitative studies emphasised that patients valued the opportunity to discuss the wider implications of their condition with a nurse 47–49 67. The TF perceived that addressing these needs includes assessment and identification of psychosocial problems, counselling and referral to other health professionals when needed, which are key components of nursing care, and described in one report of practice experience 71.…”

Section: Resultsmentioning

confidence: 99%

“…Evidence from RCTs also showed that nurse-led care improved patient activation, self-efficacy for physical activity and motivation, as well as patients’ self-assessment 7 11 34 35. A recent cohort study and several descriptive studies found that nurse-led interventions enhanced patients’ confidence in facilitating their daily life, behavioural change and coping with disease fluctuations 47–49 67 78–80. The TF discussed the terms ‘empowerment’ and ‘sense of control’, which were used in the former recommendation No 6 (online supplementary table S4).…”

Section: Resultsmentioning

confidence: 99%

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2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis

et al. 2019

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To update the European League Against Rheumatism (EULAR) recommendations for the role of the nurse in the management of chronic inflammatory arthritis (CIA) using the most up to date evidence. The EULAR standardised operating procedures were followed. A task force of rheumatologists, health professionals and patients, representing 17 European countries updated the recommendations, based on a systematic literature review and expert consensus. Higher level of evidence and new insights into nursing care for patients with CIA were added to the recommendation. Level of agreement was obtained by email voting. The search identified 2609 records, of which 51 (41 papers, 10 abstracts), mostly on rheumatoid arthritis, were included. Based on consensus, the task force formulated three overarching principles and eight recommendations. One recommendation remained unchanged, six were reworded, two were merged and one was reformulated as an overarching principle. Two additional overarching principles were formulated. The overarching principles emphasise the nurse’s role as part of a healthcare team, describe the importance of providing evidence-based care and endorse shared decision-making in the nursing consultation with the patient. The recommendations cover the contribution of rheumatology nursing in needs-based patient education, satisfaction with care, timely access to care, disease management, efficiency of care, psychosocial support and the promotion of self-management. The level of agreement among task force members was high (mean 9.7, range 9.6-10.0). The updated recommendations encompass three overarching principles and eight evidence-based and expert opinion-based recommendations for the role of the nurse in the management of CIA.

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Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: a qualitative evidence synthesis

Karimi‐Shahanjarini

Shakibazadeh

Rashidian

et al. 2019

Cochrane Database of Systematic Reviews

101

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This review aims to explore factors affecting the implementation of initiatives to substitute doctors with nurses in primary care. The review has following specific objectives: • To identify, quality appraise and synthesise qualitative evidence on barriers and facilitators to the implementation of interventions to substitute doctors with nurses in primary care. • To integrate the findings of this review of qualitative evidence with those of the relevant Cochrane review of effects, so as to enhance and extend understanding of how these complex interventions work and how context impacts on implementation. • To identify hypotheses for subgroup analyses of future updates of the Cochrane systematic review of the effectiveness of substituting doctors with nurses. 1 Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: qualitative evidence synthesis (Protocol)

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Patients' Experiences of Nurse‐Led Screening for Cardiovascular Risk in Rheumatoid Arthritis

Abstract: When planning future screening programmes for CVD for patients with RA, it is important that the screening consultation is individualized and tailored to patients' needs and their RA. Copyright © 2015 John Wiley & Sons, Ltd.

Cited by 16 publications

References 37 publications

Patient Perception of Cardiovascular Risk in Rheumatoid Arthritis

Patient Perception of Cardiovascular Risk in Rheumatoid Arthritis

2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis

Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: a qualitative evidence synthesis

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