SAT0742-HPR European league against rheumatism recommendations for the role of the nurse (EULAR-RN) in the management of chronic inflammatory arthritis (CIA): results of patients in nordic countries
Authors: M.L. Kukkurainen, M. Kauppi, Y. van Eijk-Hustings
Journal: Annals of the Rheumatic Diseases (2018)

Background  The dissemination of the EULAR-RN in the management of CIA1 have been completed in Europe and in the USA.2 The treatment is supposed to be carried out based on shared decision making (SDM).3 Lay versions of the recommendations and input from the patient organisations are essential in the integration of the recommendations and SDM.4  Objectives  The aims of this study were to assess agreement with and application of, and identify barriers against implementing the EULAR-RN in the management of CIA iand to assess differences between individual Nordic countries.  Methods  A web-based survey was distributed using snowball sampling. Levels of agreement and application were assessed using a 0–10 rating scale (0=none, 10=full agreement/application). Reasons for disagreement with and barriers against applying each recommendation were sought. Differences between groups were assessed using the Kruskal-Wallis Test.  Results  A total of 318 patients from Finland participated in the survey. Their mean age was 52.1 years (SD 15.6). 47% had completed secondary education, 25% only primary and one third tertiary education. The mean duration of the disease was 17.7 years (SD 13.0), with a diagnosis of RA (63.5%), AS or PsA (29.8%, 6.7% respectively) and treated in general (45%), university (32%) or other hospitals. The median level of agreement was high, ranging from 8 to 10 in Finland and from 7 to 10 in the other countries. Levels of agreement with the four recommendations differed between countries. Reasons for non-complete agreement in Finland included fear of losing contact with the rheumatologist and do not accept the nurse; barriers were if service is not offered or available and nurses were too busy. The application range was 0–9 in the four countries, with some individual differences (figure 1).  Conclusions  Further work and participation of patient organisations is needed for applying the EULAR-RN and removing the barriers against it.  References  [1] van Eijk-Hustings Y, van Tubergen A, Bostrom C, Braychenko E, et al. EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis.Ann Rheum Dis2012;71:13–9. doi:10.1136/annrheumdis-2011-200185  [2] van Eijk-Hustings Y, Ndosi ME, Buss B, et al. Dissemination and evaluation of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis: results of a multinational survey among nurses, rheumatologists and patients. Rheumatology2014;53(8):1491–6. doi:10.1093/rheumatology/keu134  [3] Smolen JS, Breedveld FC, Burmester GR, Bykerk V, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis2016;75:3–15. doi:10.1136/annrheumdis-2015-207524  [4] Schipper K, Bakker M, De Wit M, Ket JCF, Abma TA. Strategies for disseminating recommendations or guidelines to patients: a systematic review. Implementation Science2016;11:82. https://doi.org/10.1186/s13012–016–0447-x  Acknowledgements  We thank The Finnish Rheumatism Association, The Finnish Society of Rheumatology Nurses and The Finnish Society for Rheumatology for assistance with the data collection.  Disclosure of Interest  None declared