Emerging trends in nurse-led programs of care for management of patients with established rheumatoid arthritis: Systematic literature review.

INTRODUCTION: In patients with rheumatoid arthritis (RA), nurses are considered as essential, not only to ensure pharmacological safety, but also in the promotion in self-care and decision-making, favouring the empowerment of patients. This systematic review aimed to summarize the available literature on the health education by the nurse in patients with RA. MATERIAL AND METHODS: Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. The search ended in August 2021. Nineteen studies were retained for inclusion and evaluated with the Scottish Intercollegiate Guidelines Network for Systematic Reviews. RESULTS: We found statistically significant improvement in self-care (five studies), disease activity (three studies), quality of life (two studies), satisfaction (five studies) and adherence (one study) with the nursing-led management of patients with established rheumatoid arthritis. DISCUSSION: Although there is solid evidence of improvement in satisfaction and self-care, there seems to be a trend also to improve other outcomes, such as DAS28, from the EULAR recommendations, the expansion of the therapeutic arsenal for rheumatoid arthritis and shared decision-making. In addition, recently and due to the implementation of new technologies, the role of the nurse has been evaluated through virtual consultations. The results of recent studies have shown that this an effective and well-accepted novel approach for the management of patients with stable rheumatoid arthritis. CONCLUSION: Our study suggests that nurse-led health education, in addition of improvement in satisfaction and self-care, improve activity disease scores in RA patients.

Emerging trends in nurse-led programs of care for management of patients with established rheumatoid arthritis: Systematic literature review / Tendencias emergentes en los programas de atención dirigidos por enfermeras para el manejo de pacientes con artritis reumatoide establecida: Revisión sistemática de la literatura

Introduction: In patients with rheumatoid arthritis (RA), nurses are considered as essential, not only to ensure pharmacological safety, but also in the promotion in self-care and decision-making, favouring the empowerment of patients. This systematic review aimed to summarize the available literature on the health education by the nurse in patients with RA. Material and methods: Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. The search ended in August 2021. Nineteen studies were retained for inclusion and evaluated with the Scottish Intercollegiate Guidelines Network for Systematic Reviews. Results: We found statistically significant improvement in self-care (five studies), disease activity (three studies), quality of life (two studies), satisfaction (five studies) and adherence (one study) with the nursing-led management of patients with established rheumatoid arthritis. Discussion: Although there is solid evidence of improvement in satisfaction and self-care, there seems to be a trend also to improve other outcomes, such as DAS28, from the EULAR recommendations, the expansion of the therapeutic arsenal for rheumatoid arthritis and shared decision-making. In addition, recently and due to the implementation of new technologies, the role of the nurse has been evaluated through virtual consultations. The results of recent studies have shown that this an effective and well-accepted novel approach for the management of patients with stable rheumatoid arthritis. Conclusion: Our study suggests that nurse-led health education, in addition of improvement in satisfaction and self-care, improve activity disease scores in RA patients.(AU)

Introducción: En los pacientes con artritis reumatoide, las enfermeras se consideran esenciales, no solo para garantizar la seguridad farmacológica, sino también en la prestación de promoción en el autocuidado y la toma de decisiones, favoreciendo el empoderamiento de los pacientes. Esta revisión sistemática tuvo como objetivo resumir la literatura disponible sobre la educación sanitaria por parte de la enfermera en pacientes con artritis reumatoide. Material y métodos: Siguiendo los procedimientos de la Colaboración Cochrane, la declaración PRISMA y la lista de comprobación PRISMA, se recuperaron los estudios cuantitativos relevantes publicados en las bases de datos CINAHL, Scopus, PubMed y Medic y, a continuación, se revisaron sistemáticamente. La búsqueda finalizó en agosto de 2021. Diecinueve estudios fueron retenidos para su inclusión y evaluados con la Scottish Intercollegiate Guidelines Network for Systematic Reviews. ResultadosSe encontró una mejoría estadísticamente significativa en el autocuidado (cinco estudios), la actividad de la enfermedad (tres estudios), la calidad de vida (dos estudios), la satisfacción (cinco estudios) y la adherencia (un estudio) con el manejo dirigido por enfermería de pacientes con artritis reumatoide establecida. Discusión: Aunque siempre ha habido evidencias de mejora en la satisfacción y el autocuidado, parece haber una tendencia a mejorar también otros resultados, como el de Disease Activity Score in 28 Joints (DAS28), a partir de las recomendaciones de la European League Against Rheumatism (EULAR), la ampliación del arsenal terapéutico para la artritis reumatoide y la toma de decisiones compartida. Además, recientemente y debido a la implantación de las nuevas tecnologías, se ha evaluado el papel de la enfermera a través de las consultas virtuales. Los resultados de estudios recientes han demostrado que se trata de un nuevo enfoque...(AU)

Persistent post-discharge symptoms after COVID-19 in rheumatic and musculoskeletal diseases.

OBJECTIVES: We aimed to describe persistent symptoms and sequelae in patients with rheumatic and musculoskeletal diseases (RMD) after admission owing to coronavirus disease 2019 (COVID-19), assessing the role of autoimmune rheumatic diseases (ARDs) compared with non-autoimmune rheumatic and musculoskeletal diseases (NARDs) on persistent symptoms and sequelae. METHODS: We performed an observational study including RMD patients who attended a rheumatology clinic in Madrid and required admission owing to COVID-19 (between March and May 2020) and survived. The study began at discharge and ran until October 2020. Main outcomes were persistence of symptoms and sequelae related to COVID-19. The independent variable was the RMD group (ARD and NARD). Covariates included sociodemographics, clinical and treatment data. We ran a multivariate logistic regression model to assess the risk of the main outcomes by RMD group. RESULTS: We included 105 patients, of whom 51.5% had ARD and 68.57% reported at least one persistent symptom. The most frequent symptoms were dyspnoea, fatigue and chest pain. Sequelae were recorded in 31 patients. These included lung damage in 10.4% of patients, lymphopenia in 10%, a central retinal vein occlusion and an optic neuritis. Two patients died. Eleven patients required re-admission owing to COVID-19 problems (16.7% ARD vs 3.9% NARD; P = 0.053). No statistically significant differences were found between RMD groups in the final models. CONCLUSION: Many RMD patients have persistent symptoms, as in other populations. Lung damage is the most frequent sequela. Compared with NARD, ARD does not seem to differ in terms of persistent symptoms or consequences, although ARD might have more re-admissions owing to COVID-19.