TY - JOUR T1 - Screening for and management of comorbidities after a nurse-led program: results of a 3-year longitudinal study in 769 established rheumatoid arthritis patients JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2019-000914 VL - 5 IS - 2 SP - e000914 AU - Laure Gossec AU - Martin Soubrier AU - Frantz Foissac AU - Anna Molto AU - Pascal Richette AU - Catherine Beauvais AU - Adeline Ruyssen-Witrand AU - Aleth Perdriger AU - Isabelle Chary-Valckenaere AU - Gael Mouterde AU - Emanuelle Dernis AU - Liana Euller-Ziegler AU - René-Marc Flipo AU - Mélanie Gilson AU - Sandrine Guis AU - Xavier Mariette AU - Sophie Pouplin AU - Thierry Marhadour AU - Thierry Schaeverbeke AU - Christelle Sordet AU - Françoise Fayet AU - Maxime Dougados Y1 - 2019/06/01 UR - http://rmdopen.bmj.com/content/5/2/e000914.abstract N2 - Background/purpose Cardiovascular (CV) risk, cancer, infections and osteoporosis should be screened for in rheumatoid arthritis (RA). The objective was to assess 3-year effects of a nurse visit for comorbidity counselling.Methods This was an open long-term (3 years) extension of the Comorbidities and Education in Rheumatoid Arthritis 6-month randomised controlled trial in which patients with definite, stable RA were visiting a nurse for comorbidity counselling. Comorbidity status was assessed and nurses provided advice on screening and management, at baseline and 3 years later. A score was developed to quantify comorbidity screening and management: 0–100, where lower scores indicate better screening and management. The score was compared between baseline and 3-year assessment using a Wilcoxon test for paired data.Results Of the 970 recruited patients, 776 (80%) were followed-up at 2–4 years and 769 (79%) had available data for comorbidities at both time points: mean (±SD) age 58 (±11) years and mean disease duration 14 (±10) years; 614 (80%) were women, the mean Disease Activity Score 28 was 3.0±1.3, and 538 (70%) were receiving a biologic. At baseline, the mean comorbidity screening score was 36.6 (±19.9) and it improved at 3 years to 24.3 (±17.8) (p<0.0001), thus with a relative improvement of 33% (improvement of 12 points). CV risk screening, vaccination status and bone densitometry performance improved the most.Conclusions Comorbidity screening was suboptimal but improved notably over 3 years, after a nurse-led programme aiming at checking systematically for comorbidity screening and giving patient advice. This long-term efficacy pleads in favour of nurse-led interventions to better address comorbidities in RA.Trial registration number NCT01315652 ER -