The effect of a nurse-led prednisolone tapering regimen in polymyalgia rheumatica: a retrospective cohort study

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The objective of this study is to investigate the efficacy of a nurse-led prednisolone tapering regime in patients with polymyalgia rheumatica (PMR) compared to standard care. It is a single-center retrospective cohort study evaluating dose and percentage of patients receiving prednisolone after 1 and 2 years. A nurse-led PMR clinic was introduced June 2015 and patients diagnosed until June 2017 were included. Patients were diagnosed by a rheumatologist, and subsequently managed by nurses according to a specific protocol. Patients diagnosed with PMR between June 2012 and June 2015 served as controls. They received standard care by a rheumatologist. Sixty-eight patients received standard care and 107 nurse-led care. After 1 year, 71% of patients receiving standard care vs. 64% receiving nurse-led care took prednisolone (p = 0.441). Median (interquartile range) prednisolone dose after 1 year was 3.75 mg (0–5) in the standard care group and 1.25 mg (0–3.75) in the nurse-led care group (p = 0.004). After 2 years, 41% of patients receiving standard care vs. 18% receiving nurse-led care took prednisolone (p = 0.003). Prednisolone dose after 2 years was 0 mg (0–2.5) in the standard care group and 0 mg (0–0) in the nurse-led care group (p = 0.004). There was no difference regarding relapse and initiation of methotrexate. The number of patient contacts was 12.5 (5–16.5) in the standard care group vs. 17 (13–23) in the nurse-led care group (p = 0.001). A tight and systematic approach to prednisolone tapering is more effective than standard care, but more frequent patient contacts were necessary to obtain this effect.

Original languageEnglish
JournalRheumatology International
Volume41
Issue3
Pages (from-to)605–610
Number of pages6
ISSN0172-8172
DOIs
Publication statusPublished - Mar 2021

    Research areas

  • Nurse-led care, Polymyalgia rheumatica, Prednisolone, Tapering regimen, THERAPY, EFFICACY, STRATEGY, DOUBLE-BLIND, METHOTREXATE, RISK, DURATION, GIANT-CELL ARTERITIS

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