Comparing nurse-led and rheumatologist-led care for rheumatoid arthritis patients: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE

This study aimed to compare nurse-led and rheumatologist-led management approaches for patients with rheumatoid arthritis, as previous studies yielded inconsistent results.

METHOD

This study explored the PubMed, Embase, and Web of Science databases for research comparing these two therapy methods for individuals with rheumatoid arthritis. Outcomes analyzed were the Health Assessment Questionnaire, fatigue, stiffness, Disease Activity Score for 28 joints using C-reactive protein, Disease Activity Score for 28 joints, erythrocyte sedimentation rate, C-reactive protein, and visual analog scale pain score.

RESULTS

Six randomized controlled trials with 1,093 patients were included following the Cochrane Collaboration principles. The baseline parameters were similar between groups, except for the Disease Activity Score for 28 joints, satisfaction levels, and disease duration. Pooled analyses demonstrated that the nurse-led care group tended to improve relevant assessment indicators relative to the rheumatologist-led care group.

CONCLUSION

The meta-analysis results suggest that rheumatoid arthritis patients in nurse-led care tend to have a better functional status and disease activity trend than those in rheumatologist-led care.