Evid Based Nurs 4:51 doi:10.1136/ebn.4.2.51
  • Treatment

A shared care system of hospital follow up reduced pain and use of healthcare resources and increased satisfaction in patients with rheumatoid arthritis

 QUESTION: Is a patient and general practitioner initiated shared care system more effective than traditional rheumatologist initiated hospital care in patients with established rheumatoid arthritis?


Randomised {allocation concealed}*, unblinded, controlled trial with 2 years of follow up.


A rheumatology outpatient department in Bristol, UK.


209 patients who had established rheumatoid arthritis (mean disease duration 11.5 y). 182 patients (87%) (mean age 58 y, 68% women) had complete follow up.


105 patients were allocated to a shared care system of no routine hospital follow up but with rapid access to multidisciplinary team review on request by patients or general practitioners (GPs) (shared care group). The patients or GPs requested review by any team member through a telephone helpline staffed by a nurse who also gave general advice or assistance. The maximum wait for review was 10 working days. …

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