Patient Satisfaction and Costs of Multidisciplinary Models of Care in Rheumatology: a Review of the Recent Literature

Jill Hall, K. Julia Kaal, Junho Lee, Ross Duncan, Nicole Tsao, Mark Harrison

A number of novel models of care utilizing allied healthcare professionals, including nurses and pharmacists, have emerged as an alternate to rheumatologist specialist care to achieve disease outcomes in patients with inflammatory arthritis. We conducted a review of the literature for studies from the past 5 years that reported on measures of patient satisfaction and/or any health economic outcome in a model of care where the care providers had substantial, but not completely independent, responsibility. Previous reviews have summarized the available evidence for collaborative models of care led by nurses (only), which demonstrate that patients with inflammatory arthritis achieve similar disease outcomes and feel well supported with their person-centered care. Patients are generally highly satisfied with the care provided in collaborative care models, in line with if not greater than that provided by rheumatologists. However, we identified substantial variability in direct costs and/or overall intervention costs and measures of health-related quality of life across the various countries and healthcare systems. Overall, nursing-led interventions likely cost more than do physician-led models of care in the short-term but may lead to greater quality of life, as demonstrated with a disease-specific measure.