Specialized rheumatology nurse substitutes for rheumatologists in the diagnostic process of fibromyalgia: a cost-consequence analysis and a randomized controlled trial.

M.E. Kroese; J.L. Severens; G.J.C. Schulpen; M.C.M. Bessems; F.J. Nijhuis; R.B. Landewé

doi:10.3899/jrheum.100753

Specialized rheumatology nurse substitutes for rheumatologists in the diagnostic process of fibromyalgia: a cost-consequence analysis and a randomized controlled trial.

M.E. Kroese^*, J.L. Severens, G.J.C. Schulpen, M.C.M. Bessems, F.J. Nijhuis, R.B. Landewé

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective. To perform a cost-consequence analysis of the substitution of specialized rheumatology nurses (SRN) for rheumatologists (RMT) in the diagnostic process of fibromyalgia (FM), using both a healthcare and societal perspective and a 9-month period.

Methods. Alongside a randomized controlled trial, we measured costs and consequences of a nurse-led diagnostic consult (SRN group, n = 97) versus a rheumatologist-led diagnostic consult [usual care (UC) group, n = 96]. Patients were followed for 9 months. Every second month a questionnaire on medical consumption and social participation was filled out. Satisfaction was measured 1 week after the first consultation. During followup, health status was measured by health-related quality of life (EQ-5D), functional status (Fibromyalgia Impact Questionnaire), fatigue (Checklist Individual Strength), and self-efficacy (Generalized Self-Efficacy Scale).

Results. Patients in the SRN group were significantly more satisfied. Improvements in health status were similar in both groups after 9 months of followup. Total costs for healthcare consumption and patient and family costs were significantly lower in the SRN group ((sic)1298 vs (sic)1644; difference (sic)346; 95% CI -(sic)746 to -(sic)2). Total societal costs were (sic)3853 per patient for the SRN group and (sic)5293 for the UC group after 9 months of followup (difference (sic)1440; 95% CI -(sic)3721 to (sic)577).

Conclusion. From both a healthcare and societal perspective, the nurse-led diagnostic process can be recommended. Patients in the SRN group were significantly more satisfied, improvements in health status were similar in both groups, and total societal costs were lower for the SRN group compared to the RMT group after 9 months' followup. Registered with Current Controlled Trials, no. ISRCTN77212411. (First Release April 1 2011; J Rheumatol 2011;38:1413-22; doi:10.3899/jrheum.100753)

Original language	English
Pages (from-to)	1413-1422
Number of pages	10
Journal	Journal of Rheumatology
Volume	38
Issue number	7
DOIs	https://doi.org/10.3899/jrheum.100753
Publication status	Published - Jul 2011

Keywords

FIBROMYALGIA
COSTS AND COST ANALYSIS
OUTCOME AND PROCESS ASSESSMENT
CLINICAL TRIAL
QUALITY-OF-LIFE
HEALTH-CARE COSTS
ANKYLOSING-SPONDYLITIS
IMPACT QUESTIONNAIRE
ECONOMIC EVALUATIONS
SERVICE UTILIZATION
CURRENT STATE
BASE-LINE
PAIN
PRODUCTIVITY

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@article{bb778c6306e9464ca18e46b7c8d2b95c,

title = "Specialized rheumatology nurse substitutes for rheumatologists in the diagnostic process of fibromyalgia: a cost-consequence analysis and a randomized controlled trial.",

abstract = "Objective. To perform a cost-consequence analysis of the substitution of specialized rheumatology nurses (SRN) for rheumatologists (RMT) in the diagnostic process of fibromyalgia (FM), using both a healthcare and societal perspective and a 9-month period.Methods. Alongside a randomized controlled trial, we measured costs and consequences of a nurse-led diagnostic consult (SRN group, n = 97) versus a rheumatologist-led diagnostic consult [usual care (UC) group, n = 96]. Patients were followed for 9 months. Every second month a questionnaire on medical consumption and social participation was filled out. Satisfaction was measured 1 week after the first consultation. During followup, health status was measured by health-related quality of life (EQ-5D), functional status (Fibromyalgia Impact Questionnaire), fatigue (Checklist Individual Strength), and self-efficacy (Generalized Self-Efficacy Scale).Results. Patients in the SRN group were significantly more satisfied. Improvements in health status were similar in both groups after 9 months of followup. Total costs for healthcare consumption and patient and family costs were significantly lower in the SRN group ((sic)1298 vs (sic)1644; difference (sic)346; 95% CI -(sic)746 to -(sic)2). Total societal costs were (sic)3853 per patient for the SRN group and (sic)5293 for the UC group after 9 months of followup (difference (sic)1440; 95% CI -(sic)3721 to (sic)577).Conclusion. From both a healthcare and societal perspective, the nurse-led diagnostic process can be recommended. Patients in the SRN group were significantly more satisfied, improvements in health status were similar in both groups, and total societal costs were lower for the SRN group compared to the RMT group after 9 months' followup. Registered with Current Controlled Trials, no. ISRCTN77212411. (First Release April 1 2011; J Rheumatol 2011;38:1413-22; doi:10.3899/jrheum.100753)",

keywords = "FIBROMYALGIA, COSTS AND COST ANALYSIS, OUTCOME AND PROCESS ASSESSMENT, CLINICAL TRIAL, QUALITY-OF-LIFE, HEALTH-CARE COSTS, ANKYLOSING-SPONDYLITIS, IMPACT QUESTIONNAIRE, ECONOMIC EVALUATIONS, SERVICE UTILIZATION, CURRENT STATE, BASE-LINE, PAIN, PRODUCTIVITY",

author = "M.E. Kroese and J.L. Severens and G.J.C. Schulpen and M.C.M. Bessems and F.J. Nijhuis and R.B. Landew{\'e}",

year = "2011",

month = jul,

doi = "10.3899/jrheum.100753",

language = "English",

volume = "38",

pages = "1413--1422",

journal = "Journal of Rheumatology",

issn = "0315-162X",

publisher = "Journal of Rheumatology Publishing Co. Ltd.",

number = "7",

}

Specialized rheumatology nurse substitutes for rheumatologists in the diagnostic process of fibromyalgia: a cost-consequence analysis and a randomized controlled trial. / Kroese, M.E.; Severens, J.L.; Schulpen, G.J.C. et al.
In: Journal of Rheumatology, Vol. 38, No. 7, 07.2011, p. 1413-1422.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Specialized rheumatology nurse substitutes for rheumatologists in the diagnostic process of fibromyalgia: a cost-consequence analysis and a randomized controlled trial.

AU - Kroese, M.E.

AU - Severens, J.L.

AU - Schulpen, G.J.C.

AU - Bessems, M.C.M.

AU - Nijhuis, F.J.

AU - Landewé, R.B.

PY - 2011/7

Y1 - 2011/7

N2 - Objective. To perform a cost-consequence analysis of the substitution of specialized rheumatology nurses (SRN) for rheumatologists (RMT) in the diagnostic process of fibromyalgia (FM), using both a healthcare and societal perspective and a 9-month period.Methods. Alongside a randomized controlled trial, we measured costs and consequences of a nurse-led diagnostic consult (SRN group, n = 97) versus a rheumatologist-led diagnostic consult [usual care (UC) group, n = 96]. Patients were followed for 9 months. Every second month a questionnaire on medical consumption and social participation was filled out. Satisfaction was measured 1 week after the first consultation. During followup, health status was measured by health-related quality of life (EQ-5D), functional status (Fibromyalgia Impact Questionnaire), fatigue (Checklist Individual Strength), and self-efficacy (Generalized Self-Efficacy Scale).Results. Patients in the SRN group were significantly more satisfied. Improvements in health status were similar in both groups after 9 months of followup. Total costs for healthcare consumption and patient and family costs were significantly lower in the SRN group ((sic)1298 vs (sic)1644; difference (sic)346; 95% CI -(sic)746 to -(sic)2). Total societal costs were (sic)3853 per patient for the SRN group and (sic)5293 for the UC group after 9 months of followup (difference (sic)1440; 95% CI -(sic)3721 to (sic)577).Conclusion. From both a healthcare and societal perspective, the nurse-led diagnostic process can be recommended. Patients in the SRN group were significantly more satisfied, improvements in health status were similar in both groups, and total societal costs were lower for the SRN group compared to the RMT group after 9 months' followup. Registered with Current Controlled Trials, no. ISRCTN77212411. (First Release April 1 2011; J Rheumatol 2011;38:1413-22; doi:10.3899/jrheum.100753)

AB - Objective. To perform a cost-consequence analysis of the substitution of specialized rheumatology nurses (SRN) for rheumatologists (RMT) in the diagnostic process of fibromyalgia (FM), using both a healthcare and societal perspective and a 9-month period.Methods. Alongside a randomized controlled trial, we measured costs and consequences of a nurse-led diagnostic consult (SRN group, n = 97) versus a rheumatologist-led diagnostic consult [usual care (UC) group, n = 96]. Patients were followed for 9 months. Every second month a questionnaire on medical consumption and social participation was filled out. Satisfaction was measured 1 week after the first consultation. During followup, health status was measured by health-related quality of life (EQ-5D), functional status (Fibromyalgia Impact Questionnaire), fatigue (Checklist Individual Strength), and self-efficacy (Generalized Self-Efficacy Scale).Results. Patients in the SRN group were significantly more satisfied. Improvements in health status were similar in both groups after 9 months of followup. Total costs for healthcare consumption and patient and family costs were significantly lower in the SRN group ((sic)1298 vs (sic)1644; difference (sic)346; 95% CI -(sic)746 to -(sic)2). Total societal costs were (sic)3853 per patient for the SRN group and (sic)5293 for the UC group after 9 months of followup (difference (sic)1440; 95% CI -(sic)3721 to (sic)577).Conclusion. From both a healthcare and societal perspective, the nurse-led diagnostic process can be recommended. Patients in the SRN group were significantly more satisfied, improvements in health status were similar in both groups, and total societal costs were lower for the SRN group compared to the RMT group after 9 months' followup. Registered with Current Controlled Trials, no. ISRCTN77212411. (First Release April 1 2011; J Rheumatol 2011;38:1413-22; doi:10.3899/jrheum.100753)

KW - FIBROMYALGIA

KW - COSTS AND COST ANALYSIS

KW - OUTCOME AND PROCESS ASSESSMENT

KW - CLINICAL TRIAL

KW - QUALITY-OF-LIFE

KW - HEALTH-CARE COSTS

KW - ANKYLOSING-SPONDYLITIS

KW - IMPACT QUESTIONNAIRE

KW - ECONOMIC EVALUATIONS

KW - SERVICE UTILIZATION

KW - CURRENT STATE

KW - BASE-LINE

KW - PAIN

KW - PRODUCTIVITY

U2 - 10.3899/jrheum.100753

DO - 10.3899/jrheum.100753

M3 - Article

SN - 0315-162X

VL - 38

SP - 1413

EP - 1422

JO - Journal of Rheumatology

JF - Journal of Rheumatology

IS - 7

ER -

Specialized rheumatology nurse substitutes for rheumatologists in the diagnostic process of fibromyalgia: a cost-consequence analysis and a randomized controlled trial.

Abstract

Keywords

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