Norwich Medical School, University of East Anglia, NR4 7TJ, Norwich, Norfolk, UK.
BMC Health Serv Res. 2012 May 20;12:119. doi: 10.1186/1472-6963-12-119.
Services for Rheumatoid Arthritis (RA) have evolved with the development of independently led outreach Rheumatology Practitioner (RP) clinics in Primary Care (PC). Their clinical and cost effectiveness, compared with Secondary Care (SC) services, has not been assessed. The RECIPROCATE study aims to evaluate their clinical and cost effectiveness. This part of the study aimed to explore health professionals' opinions of rheumatology outreach service.
Using a qualitative design, semi-structured interviews were conducted with GPs, practice nurses, hospital doctors and RPs, from one hospital and seven PC practices in Norfolk, to elicit their opinions of the service. The interviews were analysed using thematic analysis.
All participants agreed the service was supportive and valuable providing high quality personalised care, disease management, social, and educational support. Advantages identified included convenience, continuity of care and proximity of services to home. RPs helped bridge the communication gap between PC and SC. Some participants suggested having a doctor alongside RPs. The service was considered to be cost effective for patients but there was uncertainty about cost effectiveness for service providers. Few disadvantages were identified the most recurring being the lack of other onsite services when needed. It was noted that more services could be provided by RPs such as prescribing and joint injections as well as playing a more active role in knowledge transfer to PC.
Professionals involved in the care of RA patients recognised the valuable role of the RP outreach clinics. This service can be further developed in rheumatology and the example can be replicated for other chronic conditions.
随着独立领导的基层医疗（PC）外联风湿病从业者（RP）诊所的发展，类风湿关节炎（RA）的服务也在不断发展。与二级保健（SC）服务相比，其临床和成本效益尚未得到评估。RECPROCATE 研究旨在评估其临床和成本效益。本研究的这一部分旨在探讨卫生专业人员对风湿病外联服务的意见。
采用定性设计，对来自诺福克一家医院和七家 PC 实践的全科医生、执业护士、医院医生和 RP 进行半结构化访谈，以了解他们对该服务的意见。使用主题分析对访谈进行分析。
所有参与者都认为该服务具有支持性和价值，提供高质量的个性化护理、疾病管理、社会和教育支持。确定的优势包括便利性、护理的连续性以及服务与家庭的接近度。RP 有助于弥合 PC 和 SC 之间的沟通差距。一些参与者建议在 RP 旁边配备医生。该服务被认为对患者具有成本效益，但服务提供者的成本效益存在不确定性。很少有缺点被确定，最常见的是当需要时缺乏其他现场服务。有人指出，RP 可以提供更多的服务，如处方和关节注射，并在向 PC 传递知识方面发挥更积极的作用。
参与 RA 患者护理的专业人员认识到 RP 外联诊所的宝贵作用。这项服务可以在风湿病学中进一步发展，并可以为其他慢性疾病复制这一范例。
