Does the nurse-led case management benefit rheumatoid arthritis patients in reducing distressing symptoms and C-reactive protein: a 2-year follow-up study in Taiwan Provisionally Accepted

Wei-Chiao Chang¹ Hanoch Livneh² Hua-Lung Huang¹ Hsin-Hua Li¹ Ming-Chi Lu¹ Miao-Chiu Lin¹ We IJen Chen^1* Tzung-Yi Tsai^1*

• ¹Dalin Tzu Chi Hospital, Taiwan
• ²Portland University, United States

Background: Rheumatoid arthritis (RA) is an chronic disease and may worsen over time. Today, the nurse-led case management (NLCM) has been recommended to improve clinical outcomes for chronic diseases patients, yet little is known regarding its impact on pain, fatigue and C-reactive protein (CRP) among RA patients. We aimed to explore this issue among such groups via a two-group pre-and post-test approach.Methods: All subjects were recruited from one hospital in Taiwan from January 2017 to June 2018 and assigned to either a six-month NLCM program in addition to usual care, or to a control group which received usual care only. All of them were followed for two years. Outcomes of interests were compared at four timepoints: baseline, the third day after NLCM completion, and at 6 and 24 months after NLCM. Effects between them were tested using the generalized estimating equations (GEE) model after adjusting for differences at baseline.: A total of 50 patients in the NLCM group and 46 in the control group were recruited for data analysis. Results from the GEE model indicated that integrating NLCM into conventional care benefited patients in decreasing levels of pain and fatigue, as well as CRP value. These improvements were still observed for two years after NLCM.NLCM was shown to be helpful in lowering pain, fatigue and CRP, implicating that NLCM may be a reference in the provision of tailored care for those affected by rheumatism.