The Essential Role of Nurses in Managing Rheumatic Musculoskeletal Conditions

Recent research underscores the vital contributions that nurses make in the management of rheumatic musculoskeletal diseases, as highlighted by the European Alliance of Associations for Rheumatology (EULAR). In light of a growing shortage of rheumatologists across Europe, the involvement of nurses in patient care has become increasingly essential.

EULAR's guidelines emphasize the significance of nurses in delivering evidence-based care, facilitating shared decision-making, and providing comprehensive support to patients. This includes education tailored to individual needs, ensuring satisfaction with care, and promoting self-management among patients with chronic inflammatory arthritis.

At the 2025 EULAR congress held in Barcelona, two pivotal studies were presented that demonstrate the advantages of nurse-led care in enhancing patient outcomes and optimizing healthcare resources. One study focused on how nurse-led initiatives in home monitoring can align with treat-to-target (T2T) strategies for managing gout. This approach combines patient self-monitoring with professional guidance, reducing the need for frequent physician visits while maintaining quality of care.

In a comparative analysis conducted by Jeffrey van der Ven, the cost-effectiveness of nurse-led home monitoring of serum urate levels was evaluated. This innovative model allows specialized rheumatology nurses to assist patients in managing their treatment from home, utilizing point-of-care testing for serum urate. Traditional management methods, in contrast, require patients to attend hospital-based appointments for laboratory tests and rheumatologist consultations.

The findings indicated that home monitoring not only proved to be cost-effective, yielding a mean incremental net monetary benefit of EUR130, but also optimized the use of rheumatologists' time. The intervention allowed rheumatologists to save an average of 42.7 minutes, while nurses engaged in an additional 51.2 minutes of patient interaction. This time reallocation can enable rheumatologists to accommodate more new patients in their schedules.

Another study presented by Theresa May explored the implementation of group education clinics led by nurse practitioners to expedite the initiation of biologic therapies for patients with inflammatory arthritis. The innovative approach involved grouping patients into sessions of three to four, where they received comprehensive education about treatment options, benefits, risks, and monitoring in a 30-minute session.

The quality improvement project demonstrated a significant reduction in waiting times for patients, decreasing from an average of 46 days to just 10 days from treatment decision to educational appointment. Moreover, the capacity for patient education in these clinics increased from six to 12-18 patients per session, thereby enhancing access to vital information and support.

Patient feedback on these group sessions was overwhelmingly positive, with participants rating the overall quality at an impressive 9.85 out of 10 and their confidence in understanding biologic treatments at 9.42. The results affirm that nurse-led group education clinics are an effective strategy for minimizing wait times and improving patient satisfaction.

In summary, the growing body of evidence highlights the indispensable role of nurses in the management of rheumatic musculoskeletal diseases. Their contributions not only improve patient outcomes but also help to streamline healthcare delivery in the face of increasing demands on rheumatology services.