© 1994 British Society for Rheumatology
research-article |
AN EVALUATION OF THE EFFECTIVENESS, SAFETY AND ACCEPTABILITY OF A NURSE PRACTITIONER IN A RHEUMATOLOGY OUTPATIENT CLINIC
*Clinical Pharmacology Unit (Rheumatology and Rehabilitation Research Unit), University Department of Medicine, Royal Bath Hospital and The General Infirmary at Leeds Harrogate
St James's University Hospital Leeds
Correspondence to:
J. Hill, Clinical Pharmacology Unit, Royal Bath Hospital, Harrogate, North Yorkshire HG1 2PS.
Seventy patients with RA were randomly allocated to either a Rheumatology Nurse Practitioner (RNP) or Consultant Rheumatologist (CR) clinic. They were seen on six occasions in 1 year. Effectiveness and safety were assessed by biochemical, clinical, psychological and functional variables; patient knowledge and satisfaction were measured by questionnaire.
At week 0 the groups were well matched clinically and demographically. By week 48 significant improvements had occurred in plasma viscosity and articular index within both groups. In patients managed by the RNP, pain, morning stiffness, psychological status, patient knowledge and satisfaction had all improved significantly (P = 0.001; P = 0.028; P = 0.0005; P<0.0001; P<0.0001 respectively), improvements not mirrored by the CR cohort.
Between group comparisons also showed significant differences by the end of the study. Compared to the CR patients, the RNP suffered from lower levels of pain (P<0.05), had acquired greater levels of knowledge (P<0.0001) and were significantly more satisfied with their care (P<0.0001).
KEY WORDS: Nurse practitioner, Outpatient clinic, Effectiveness, Safety, Acceptability
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