Lower RA activity for patients seen at practices with NPs, PAs

(HealthDay)—Patients with rheumatoid arthritis (RA) have lower disease activity when seen at practices with nurse practitioners (NPs) or physician assistants (PAs) versus rheumatologist-only practices, according to a study published in the December issue of Arthritis Care & Research.

Daniel H. Solomon, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues compared outcomes in seven U.S. rheumatology practices (four with and three without NPs and PAs). They extracted data on RA disease activity from medical records for the last two years. Disease activity was compared adjusting for disease duration, serological status, RA treatments, and disease activity measures.

Records were reviewed for 301 patients (mean age, 61 years; 77 percent female), representing 1,982 visits. The researchers found that, compared to patients seen in rheumatologist-only practices, patients seen in practices with NPs and PAs were less likely to have higher disease activity (odds ratio, 0.32; P = 0.004), in the primary adjusted analysis. No differences were seen in the change in disease activity.

"Patients seen in practices with NPs or PAs had lower RA disease activity over two years compared to those seen in rheumatologist-only practices; no differences were observed in the change in disease activity between visits either within or between the different types of provider practice," the authors write.

One author disclosed financial ties to UpToDate.

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