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Evaluation of the impact of a nurse-led program of systematic screening of comorbidities in patients with axial spondyloarthritis: The results of the COMEDSPA prospective, controlled, one year randomized trial.

Authors :
Molto, Anna
Gossec, Laure
Poiraudeau, Serge
Claudepierre, Pascal
Soubrier, Martin
Fayet, Françoise
Wendling, Daniel
Gaudin, Philippe
Dernis, Emmanuelle
GUIS, Sandrine
Pouplin, Sophie
Ruyssen, Adeline
Chales, Gerard
Mariette, Xavier
Beauvais, Catherine
Combe, Bernard
Flipo, René-Marc
Richette, Pascal
Chary-Valckenaere, Isabelle
Saraux, Alain
Source :
Seminars in Arthritis & Rheumatism; Aug2020, Vol. 50 Issue 4, p701-708, 8p, 3 Charts
Publication Year :
2020

Abstract

To evaluate the impact of a nurse-led program of systematic screening for the management (detection/prevention) of comorbidities. Prospective, randomized, controlled, open, 12-month trial (NCT02374749). Participants : consecutive patients with axial Spondyloarthritis (axSpA) (according to the rheumatologist) A nurse collected data on comorbidities during a specific outpatient visit. In the event of non-agreement with recommendations, the patient was informed and a specific recommendation was given to the patient (orally and in a with a detailed written report). Patients were seen after one year in a nurse-led visit. random allocation (i.e. either this program or an educational program not presented here and considered here as the control group). : change after one year of a weighted comorbidity management score (0 to 100 where 0= optimal management). 502 patients were included (252 and 250 in the active and control groups, respectively): age: 47±12 years, male gender: 63%, disease duration: 14±11y. After one year, no differences were observed in a weighted comorbidity management score. However, the number of patients in agreement with recommendations was significantly higher in the active group for vaccinations (flu vaccination: 28.6% vs. 9.9%, p<0.01; pneumococcal vaccination:40.0% vs. 21.1%,p=0.04), for cancer screening (skin cancer screening: 36.3% vs. 17.2%, p=0.04) and for osteoporosis (bone densitometry performed: 22.6% vs. 8.7%, p<0.01; Vitamin D supplementation initiation: 51.9% vs. 9.4%, p<0.01). This study suggests the short-term benefit of a single-visit nurse-led program for systematic screening of comorbidities for its management in agreement with recommendations, even in this young population of patients with axSpA. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00490172
Volume :
50
Issue :
4
Database :
Supplemental Index
Journal :
Seminars in Arthritis & Rheumatism
Publication Type :
Academic Journal
Accession number :
145651414
Full Text :
https://doi.org/10.1016/j.semarthrit.2020.05.012