The Effectiveness of Nurse‐Led Care in Patients With Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis of Randomised Controlled Studies

AIMS AND OBJECTIVES: To evaluate the effectiveness of nurse-led care (NLC) in patients with rheumatoid arthritis on disease activity, physical function, fatigue, satisfaction, pain, and quality of life. BACKGROUND: Rheumatoid arthritis is a chronic autoimmune disease, which may not respond to insufficient rheumatology care capacity and workforce shortage. NLC is a care delivery model that can help address this shortage and improve disease management. DESIGN: Systematic review and meta-analysis. METHODS: Nine databases were independently searched by two reviewers for eligible studies. Randomised controlled studies evaluating the effects of NLC on disease activity, physical function, fatigue, satisfaction, and other outcomes were included. The cochrane risk of bias tool was used to assess the risk of bias. RESULTS: A total of nine studies involving 1447 participants were included. The pooled results indicated that no significant difference in disease activity was found at 0.5 years of follow-up (SMD: -0.33, 95% CI [-0.70, 0.04]), and a significant difference was seen in favour of NLC at 1 year (SMD: -0.35, 95% CI [-0.48, -0.10]), and 2 years (SMD: -0.29, 95% CI [-0.48, -0.10]). Moreover, no significant difference was found in fatigue and satisfaction at 0.5 years of follow-up, whereas differences in favour of NLC were seen at 1 year. In addition, no significant difference was found in physical function, pain, and quality of life. CONCLUSIONS: This review indicated that NLC was not inferior to other types of care, and even had a better positive impact on disease activity, fatigue, and satisfaction for patients with rheumatoid arthritis. RELEVANCE TO CLINICAL PRACTICE: Our study demonstrates that NLC is an effective approach to managing rheumatoid arthritis and recommends medical practitioners be well-versed in its importance. NO PATIENT OR PUBLIC CONTRIBUTION: Patients or public members were not directly involved in this study. TRIAL REGISTRATION: ClinicalTrials.gov identifier: CRD42022355963.