Dataset Information

Impact of a nurse-led programme on comorbidity management and impact of a patient self-assessment of disease activity on the management of rheumatoid arthritis: results of a prospective, multicentre, randomised, controlled trial (COMEDRA).

ABSTRACT:

Objectives

Rheumatoid arthritis (RA) patients are at an increased risk of developing comorbid conditions. A close monitoring of the disease targeting a status of low disease activity is associated with a better outcome. The aim of this trial was to evaluate the impact of a nurse-led programme on comorbidities and the impact of patient self-assessment of disease activity on the management of RA.

Methods

We enrolled 970 patients (mean age 58 years, 79% women) in a prospective, randomised, controlled, open-label, 6-month trial. In the comorbidity group (n=482), the nurse checked comorbidities and sent the programme results to the attending physicians. In the self-assessment group (n=488), the nurse taught the patient how to calculate his/her Disease Activity Score which had to be reported on a booklet to be shared with the treating rheumatologist. The number of measures taken for comorbidities and the percentage of patients recording a change (initiation, switch or increased dose) in disease-modifying antirheumatic drugs (DMARDs) in the 6 months follow-up period of the study defined the outcomes of the trial.

Results

The number of measures taken per patient was statistically higher in the comorbidity group: 4.54±2.08 versus 2.65±1.57 (p<0.001); incidence rate ratio: 1.78 (1.61-1.96) and DMARD therapy was changed more frequently in the self-assessment group: 17.2% versus 10.9% (OR=1.70 (1.17; 2.49), p=0.006).

Conclusions

This study demonstrates the short-term benefit of a nurse-led programme on RA comorbidity management and the impact of patient self-assessment of disease activity on RA treatment intensification.

Trial registration number

NCT #01315652.

SUBMITTER: Dougados M

PROVIDER: S-EPMC4552897 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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Publications

Impact of a nurse-led programme on comorbidity management and impact of a patient self-assessment of disease activity on the management of rheumatoid arthritis: results of a prospective, multicentre, randomised, controlled trial (COMEDRA).

Dougados Maxime M Soubrier Martin M Perrodeau Elodie E Gossec Laure L Fayet Françoise F Gilson Mélanie M Cerato Marie-Hélène MH Pouplin Sophie S Flipo René-Marc RM Chabrefy Laurent L Mouterde Gael G Euller-Ziegler Liana L Schaeverbeke Thierry T Fautrel Bruno B Saraux Alain A Chary-Valckenaere Isabelle I Chales Gérard G Dernis Emmanuelle E Richette Pascal P Mariette Xavier X Berenbaum Francis F Sibilia Jean J Ravaud Philippe P

Annals of the rheumatic diseases 20140528 9

<h4>Objectives</h4>Rheumatoid arthritis (RA) patients are at an increased risk of developing comorbid conditions. A close monitoring of the disease targeting a status of low disease activity is associated with a better outcome. The aim of this trial was to evaluate the impact of a nurse-led programme on comorbidities and the impact of patient self-assessment of disease activity on the management of RA.<h4>Methods</h4>We enrolled 970 patients (mean age 58 years, 79% women) in a prospective, rando ...[more]

PMID: 24872377

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Dataset Information

Impact of a nurse-led programme on comorbidity management and impact of a patient self-assessment of disease activity on the management of rheumatoid arthritis: results of a prospective, multicentre, randomised, controlled trial (COMEDRA).

Objectives

Methods

Results

Conclusions

Trial registration number

Publications

Impact of a nurse-led programme on comorbidity management and impact of a patient self-assessment of disease activity on the management of rheumatoid arthritis: results of a prospective, multicentre, randomised, controlled trial (COMEDRA).

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