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

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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 …

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  • Source of funding: NHS Research and Development.

  • For correspondence: Dr S Hewlett, Rheumatology Unit, University of Bristol Division of Medicine, Bristol Royal Infirmary, Bristol BS2 8HW, UK. Fax +44 (0)117 928 3841.

  • * Information provided by author.