Lower Rheumatoid Arthritis Activity Seen at Practices with NPs, PAs
Patients seen in practices with NPs or PAs had lower RA disease activity over 2 years compared to those seen in rheumatologist-only practices.
HealthDay News — 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, MD, MPH, from Brigham and Women's Hospital in Boston, and colleagues compared outcomes in 7 U.S. rheumatology practices (4 with and 3 without NPs and PAs). They extracted data on RA disease activity from medical records for the last 2 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 1982 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 2 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 wrote.
One author disclosed financial ties to UpToDate.
Solomon DH, Fraenkel L, Lu B, et al. Comparison of Care Provided in Practices With Nurse Practitioners and Physician Assistants Versus Subspecialist Physicians Only: A Cohort Study of Rheumatoid Arthritis. Arthritis Care & Research. 2015; doi:10.1002/acr.22643.