ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 3010

The Development and Evaluation of a Self-Monitoring and Patient-Initiated Follow-up Service for People with Rheumatoid or Psoriatic Arthritis on Methotrexate

Hayley McBain1,2, Michael Shipley3, Abigail Olaleye3, Samantha Moore4, Shashi Hirani5 and Stanton Newman6, 1Health Services Research and Management Division, City University London, London, United Kingdom, 2Community Health Newham, East London Foundation Trust, London, United Kingdom, 3University College Hospital London, London, United Kingdom, 4Rheumatology, University College London, London, United Kingdom, 5City University London, London, United Kingdom, 6School of Community & Health Sciences, City University London, London, United Kingdom

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: methotrexate (MTX), Psoriatic arthritis, rheumatoid arthritis (RA) and self-management

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Session Title: Clinical Practice/Patient Care

Session Type: Abstract Submissions (ARHP)

Background/Purpose: Patient-initiated services in rheumatology have been found to be cost-saving without compromising the clinical or psychosocial well-being of patients with rheumatoid arthritis. Self-monitoring is a technique used in many other long-term conditions and is associated with reductions in healthcare utilisation and mortality and has been found to be satisfactory from the patient’s perspective. The aim of this study was to evaluate the efficacy of a service which integrates self-monitoring into patient-initiated follow-ups for patients with RA or PsA on methotrexate; in terms of healthcare utilisation and clinical outcomes; using a mixed methods approach including a randomised controlled trial (RCT) and qualitative semi-structured interviews.

Methods: One hundred patients with RA or PsA (according to ACR/EULAR/CASPAR criteria)on methotrexate were randomised to either an intervention group or usual care. All participants were assessed over 6 blood tests. Those in the intervention group attended one training session where they were taught how to monitor their blood test results and which symptoms and side effects they should report. These participants had no scheduled appointments with their rheumatology nurse during the trial period, but continued with their consultant appointments as usual. Blood test results were sent to intervention participants and along with their assessment of symptoms and side effects; patients initiated a review with their nurse, when necessary. If these reviews were required an immediate outpatient appointment was made. Healthcare utilisation was monitored throughout the trial period. Poisson regressions and multi-level modelling were used to explore the impact of the intervention on healthcare usage and clinical outcomes.

Results: There were no significant differences in clinical or demographic variables between the two groups at baseline. Across the trial period 77% of decisions made by intervention participants were considered to be safe. At the end of the trial period participants in the intervention group had 54.55% fewer appointments with their rheumatology nurse specialist (p<0.0001). There were no significant differences in the number of appointments with the rheumatologist or GP. Levels of pain, fatigue, ESR, CRP and disease activity did not differ between groups (p>0.05). Intervention participants were positive about the new model of care, valuing its efficiency and tailored approach. The service allowed patients to gain new knowledge and use this information along with the skills they obtained to take control of their health and arthritis.

Conclusion: After brief training patients with RA and PsA can successfully understand and interpret their blood test results and use this information along with reports of their symptoms and side effects to initiate appropriate reviews with their rheumatology nurse. Participants in the intervention group had fewer hospital appointments with their nurse specialist with no detrimental effects to their clinical status and with no increase in visits to the rheumatologist or GP. This model of care offers a viable alternative for established RA and PsA patients on DMARD therapy.


Disclosure:

H. McBain,
None;

M. Shipley,
None;

A. Olaleye,
None;

S. Moore,
None;

S. Hirani,
None;

S. Newman,
None.

  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-development-and-evaluation-of-a-self-monitoring-and-patient-initiated-follow-up-service-for-people-with-rheumatoid-or-psoriatic-arthritis-on-methotrexate/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.