Nurse-Led Care Efficacious, Cost-Effective for Gout

MONDAY, Oct. 29, 2018 — For patients with gout, nurse-led care is efficacious and cost-effective compared with usual care led by general practitioners (GPs), according to a study published Oct. 20 in The Lancet.

Michael Doherty, M.D., from the University of Nottingham in the United Kingdom, and colleagues randomly assigned 517 adults who had experienced a gout flare in the last 12 months to receive nurse-led care (255 patients), which included provision of individualized information and engaging patients in shared decision making, or to continue with GP-led usual care (262 patients). Patients were assessed at baseline and after one and two years.

The researchers found high uptake of and adherence to urate-lowering therapy in association with nurse-led care. Compared with those receiving usual care, more patients receiving nurse-led care had serum urate concentrations less than 360 µmol/L at two years (95 versus 30 percent; risk ratio, 3.18). All secondary outcomes favored the nurse-led group at two years. Per quality-adjusted life year gained, the cost for the nurse-led intervention was £5,066 at two years.

“Although nurses delivered this care, the principles of patient education, treat-to-target urate-lowering strategy, and regular follow-up and monitoring are applicable to any health professional who treats people with gout. Although this takes more time with the patient to start with, long-term this becomes very cost-effective,” Doherty said in a statement.

Several authors disclosed ties to the pharmaceutical industry.

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Posted: October 2018

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