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Evaluation of the impact of nursing clinics in the rheumatology services

  • Health Services Research
  • Published:
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Abstract

Nursing clinics in rheumatology (NCRs) are organisational care models that provide care centred within the scope of a nurse’s abilities. To analyse the impact of NCR in the rheumatology services, national multicenter observational prospective cohort studied 1-year follow-up, comparing patients attending rheumatology services with and without NCR. NCR was defined by the presence of: (1) office itself; (2) at least one dedicated nurse; and (3) its own appointment schedule. Variables included were (baseline, 6 and 12 months): (a) test to evaluate clinical activity of the disease, research and training, infrastructure of unit and resources of NCR and (b) tests to evaluate socio-demographics, work productivity (WPAI), use of services and treatments and quality of life. A total of 393 rheumatoid arthritis and ankylosing spondylitis patients were included: 181 NCR and 212 not NCR, corresponding to 39 units, 21 with NCR and 18 without NCR (age 53 + 11.8 vs 56 + 13.5 years). Statistically significant differences were found in patients attended in sites without NCR, at some of the visits (baseline, 6 or 12 months), for the following parameters: higher CRP level (5.9 mg/l ± 8.3 vs 4.8 mg/l ± 7.8; p < 0.005), global disease evaluation by the patient (3.6 ± 2.3 vs 3.1 ± 2.4), physician (2.9 ± 2.1 vs 2.3 ± 2.1; p < 0.05), use of primary care consultations (2.7 ± 5.4 vs 1.4 ± 2.3; p < 0.001) and worse work productivity. The presence of NCR in the rheumatology services contributes to improve some clinical outcomes, a lower frequency of primary care consultations and better work productivity of patients with rheumatic diseases.

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Acknowledgments

This study was funded by Grant number ACA-SPAI-08-25 FER. This work was supported by an unrestricted grant from the Spanish Society of Rheumatology and Abbvie.

List of investigator for Score Working Group: Javier Alegre López: H. Universitario de Burgos (Burgos); Juan José Alegre Sancho: H. Universitario Dr. Peset (Valencia); Joaquín Belzunegui Otano: H. Universitario Donostia (San Sebastián–Guipuzcoa); Alberto Bermúdez Torrente: H. Universitario Virgen de la Arrixaca (Murcia); Sagrario Bustabad Reyes: H. Universitario de Canarias (San Cristóbal de La Laguna–Tenerife); Javier Calvo Catalá: H. General Universitario de Valencia (Valencia); José Campos Esteban: H. Puerta de Hierro (Majadahonda–Madrid); Amelia Carbonell Jorda: H. Universitario de San Juan (San Juan–Alicante); Sonia Castro Oreiro: H. Universitario Joan XXIII (Tarragona); Dacia Cerdà Gabaroi: H. Moisès Broggi (Sant Joan Despí–Barcelona); Eduardo Collantes Estevez: H. Universitario Reina Sofía (Córdoba); Montserrat Corteguera Coro: H. Nuestra Señora de Sonsoles (Ávila); Lluis Espadaler Poch: H. Universitario Son Espases (Palma de Mallorca); Cristina Fernández Carballido: H. General de Elda (Elda–Alicante); Antonio Fernández Nebro: H. General Carlos Haya (Málaga); Manuel Flores Torre: H. de Galdakao (Usansolo: Vizcaya); Rosario García de Vicuña: H. Universitario de la Princesa (Madrid); Mª Luz García Vivar: H. de Basurto (Bilbao–Vizcaya); Mª Victoria Gómez España: H. Sierrallana (Torrelavega–Cantabria); Sandra Fortea: H. de Sagunto (Sagunto–Valencia); Antonio Juan Mas: H. Son Llatzer (Palma de Mallorca); Marta Larrosa Padró: H. Corporació Sanitària Parc Taulí (Sabadell–Barcelona); Javier Manero Ruiz: H. Universitario Miguel Servet (Zaragoza); Emilio Martín Mola: H. Universitario La Paz (Madrid); Isabel Mateo Bernardo: H. Universitario Doce de Octubre (Madrid); Patricia Moya Alvarado: H. de la Santa Creu i Sant Pau (Barcelona); José Raúl Noguera Pons: H. General Universitario de Elche (Elche–Alicante); Joan Miquel Nolla Solé: H. Universitario de Bellvitge (Bellvitge–Barcelona); Enriqueta Peiró Callizo: H. Universitario Marqués de Valdecilla (Santander); Trinidad Pérez Sandoval: H. de León (León); Francisca Pina Pérez: H. General Universitario Morales Meseguer (Murcia); Javier Pino del Montes: H. Universitario de Salamanca (Salamanca); Miguel Ángel Polo Ostariz: H. Fundación Hospital Calahorra (Calahorra–Logroño); José Manuel Rodríguez Heredia: H. Universitario de Getafe (Getafe–Madrid); Carlos Rodríguez Lozano: H. Dr. Negrín (Las Palmas de Gran Canaria–Gran Canaria); Cristina Patricia Alcañiz: H. Universitario La Fe (Valencia); Susana Romero Yuste: H. Provincial de Pontevedra (Pontevedra); Rosa Roselló Pardo: H. General San Jorge (Huesca); María Rusiñol Badals: H. Universitari Mútua de Terrassa (Terrassa–Barcelona); Juana Sampedro Álvarez: H. Virgen de la Salud (Toledo); Ana Isabel Sánchez Atrio: H. Príncipe de Asturias (Alcalá de Henares–Madrid); Amalia Sánchez-Andrade Fernández: H. Complejo Hospitalario Lucus Augusti (Lugo); Juan Carlos Torre Alonso: H. Monte Naranco (Oviedo); Marta Valero Expósito: H. Universitario de Sanchinarro (Madrid); Mónica Vázquez Díaz: H. Ramón y Cajal (Madrid); Raúl Veiga Cabello: H. Universitario de Fuenlabrada (Fuenlabrada–Madrid).

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Authors and Affiliations

  1. Rheumatology Section, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes (Madrid), Universidad Europea de Madrid, Paseo de Europa 34. San Sebastián de los Reyes, 28702, Madrid, Spain

    Santiago Muñoz-Fernández & Amparo Rodríguez

  2. Madrid, Spain

    Ma Dolores Aguilar & Pablo Lázaro

  3. Rheumatology Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain

    Raquel Almodóvar

  4. Rheumatology Clinical Management Unit, Málaga Institute of Biomedical Research (Instituto de Investigación biomédica de Málaga, IBIMA), Hospital Regional de Málaga, Universidad de Málaga, Málaga, Spain

    Laura Cano-García

  5. Rheumatology Section, Hospital de Sagunto, Valencia, Spain

    Luís Antonio Gracia

  6. Research Unit from the Rheumatology Service, Hospital Universitario y Politécnico La Fe, Universidad Católica, Valencia, Spain

    José A. Román-Ivorra

  7. Rheumatology Unit, Hospital General de Vic, Vic, Barcelona, Spain

    J. Ramón Rodríguez

  8. Rheumatology Section, Hospital Universitario Infanta Leonor, Madrid, Spain

    Teresa Navío

Authors
  1. Santiago Muñoz-Fernández
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  2. Ma Dolores Aguilar
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  3. Amparo Rodríguez
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  4. Raquel Almodóvar
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  5. Laura Cano-García
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  6. Luís Antonio Gracia
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  7. José A. Román-Ivorra
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  8. J. Ramón Rodríguez
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  9. Teresa Navío
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  10. Pablo Lázaro
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Consortia

SCORE Working Group

  • Javier Alegre-López
  • , Juan José Alegre-Sancho
  • , Joaquín Belzunegui-Otano
  • , Alberto Bermúdez Torrente
  • , Sagrario Bustabad Reyes
  • , Javier Calvo-Catalá
  • , José Campos-Esteban
  • , Amelia Carbonell Jorda
  • , Sonia Castro-Oreiro
  • , Dacia Cerdá-Gabaroi
  • , Eduardo Collantes-Estevez
  • , Montserrat Corteguera Coro
  • , Lluis Espadaler Poch
  • , Cristina Fernández-Carballido
  • , Antonio Fernández Nebro
  • , Manuel Flores Torre
  • , Rosario García de Vicuña
  • , Mª Luz García Vivar
  • , Mª Victoria Gómez España
  • , Sandra Fortea
  • , Antonio Juan Mas
  • , Marta Larrosa-Padró
  • , Javier Manero Ruiz
  • , Emilio Martín-Mola
  • , Isabel Mateo-Bernardo
  • , Patricia Moya-Alvarado
  • , José Raúl Noguera-Pons
  • , Joan Miquel Nolla Soléc
  • , Enriqueta Peiró Callizo
  • , Trinidad Pérez-Sandoval
  • , Francisca Pina Pérez
  • , Javier Del Pino Montes
  • , Miguel Ángel Polo-Ostariz
  • , José Manuel Rodríguez Heredia
  • , Carlos Rodríguez Lozano
  • , Cristina Patricia Alcañiz
  • , Susana Romero-Yuste
  • , Rosa Roselló-Pardo
  • , María Rusiñol-Badals
  • , Juana Sampedro-Álvarez
  • , Ana Isabel Sánchez-Atrio
  • , Amalia Sánchez-Andrade Fernández
  • , Juan Carlos Torre Alonso
  • , Marta Valero-Expósito
  • , Mónica Vázquez-Díaz
  •  & Raúl Veiga-Cabello

Corresponding author

Correspondence to Santiago Muñoz-Fernández.

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Conflict of interest

Santiago Muñoz-Fernández, M.ª Dolores Aguilar, Amparo Rodríguez, Raquel Almodóvar, Laura Cano-García, Luís Antonio Gracia, José A. Román-Ivorra, J. Ramón Rodríguez, Teresa Navío and Pablo Lázaro declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 19634 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Muñoz-Fernández, S., Aguilar, M.D., Rodríguez, A. et al. Evaluation of the impact of nursing clinics in the rheumatology services. Rheumatol Int 36, 1309–1317 (2016). https://doi.org/10.1007/s00296-016-3518-z

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  • DOI: https://doi.org/10.1007/s00296-016-3518-z

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