{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:11:59Z","timestamp":1793412719706,"version":"4.5.0"},"reference-count":52,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T00:00:00Z","timestamp":1618531200000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014840","name":"Federal Joint Committee","doi-asserted-by":"crossref","award":["01NVF16029"],"award-info":[{"award-number":["01NVF16029"]}],"id":[{"id":"10.13039\/501100014840","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2021,4,5]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine the non-inferiority of nurse-led care (NLC) in patients with anticitrullinated protein antibody (ACPA)-positive and\/or rheumatoid factor (RF)-positive rheumatoid arthritis (RA) with active disease who are starting disease-modifying antirheumatic drug therapy, following treat-to-target (T2T) recommendations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A multicentre, pragmatic randomised controlled trial was conducted to assess clinical effectiveness, anxiety, depression and patient satisfaction following a non-inferiority design. The participants were 224 adults with ACPA\/RF-positive RA who were randomly assigned to either NLC or rheumatologist-led care (RLC). The primary outcome was the Disease Activity Score in 28 Joints measured with C reactive protein (DAS28-CRP) assessed at baseline and after 3, 6, 9 and 12 months. A DAS28-CRP difference of 0.6 was set as the non-inferiority margin. Mean differences between the groups were assessed following per-protocol and intention-to-treat strategies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Demographic data and baseline characteristics of patients in the NLC group (n=111) were comparable to those of patients in the RLC group (n=113). The improvement in disease activity (change in DAS28-CRP, primary outcome) over the course of 12 months was significant in both groups (p&lt;0.001). No significant differences were observed between the NLC and RLC groups (p=0.317). Non-inferiority of NLC was shown for the primary outcome and all secondary outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study supported the non-inferiority of NLC in managing T2T and follow-up care of patients with RA with moderate to high disease activity and poor prognostic factors in addition to RLC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>DRKS00013055.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2021-001627","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T10:39:32Z","timestamp":1618569572000},"page":"e001627","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Effect of nurse-led care on outcomes in patients with ACPA\/RF-positive rheumatoid arthritis with active disease undergoing treat-to-target: a multicentre randomised controlled trial"],"prefix":"10.1136","volume":"7","author":[{"given":"Juliana Rachel","family":"Hoeper","sequence":"first","affiliation":[{"name":"Center for Health Economics Research Hannover (CHERH), Leibniz Universit\u00e4t Hannover, Hannover, Germany"},{"name":"Rheumatologie and Immunologie, Medizinische Hochschule Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Zeidler","sequence":"additional","affiliation":[{"name":"Center for Health Economics Research Hannover (CHERH), Leibniz Universit\u00e4t Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Eileen","family":"Meyer","sequence":"additional","affiliation":[{"name":"Rheumatologie and Immunologie, Medizinische Hochschule Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Gauler","sequence":"additional","affiliation":[{"name":"Rheumapraxis an der Hase, Osnabr\u00fcck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Steffens-Korbanka","sequence":"additional","affiliation":[{"name":"Rheumapraxis an der Hase, Osnabr\u00fcck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Welcker","sequence":"additional","affiliation":[{"name":"MVZ f\u00fcr Rheumatologie, Planegg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Wendler","sequence":"additional","affiliation":[{"name":"Internistische Praxisgemeinschaft, Rheumatologie, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Schuch","sequence":"additional","affiliation":[{"name":"Internistische Praxisgemeinschaft, Rheumatologie, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"von Hin\u00fcber","sequence":"additional","affiliation":[{"name":"Praxis f\u00fcr Rheumatologie und Osteologie, Hildesheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schwarting","sequence":"additional","affiliation":[{"name":"Division of Rheumatology and Clinical Immunology, University Hospital Mainz, Mainz, Germany"},{"name":"ACURA Rheumatology Center Rhineland-Palatinate, Bad Kreuznach, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Witte","sequence":"additional","affiliation":[{"name":"Rheumatologie and Immunologie, Medizinische Hochschule Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Meyer-Olson","sequence":"additional","affiliation":[{"name":"Rheumatologie and Immunologie, Medizinische Hochschule Hannover, Hannover, Germany"},{"name":"Rheumatologie, m&i Fachklinik Bad Pyrmont, Bad Pyrmont, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4327-9836","authenticated-orcid":false,"given":"Kirsten","family":"Hoeper","sequence":"additional","affiliation":[{"name":"Rheumatologie and Immunologie, Medizinische Hochschule Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,16]]},"reference":[{"key":"2025090312315555000_7.1.e001627.1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s00393-017-0297-1","article-title":"[Memorandum of the German Society for Rheumatology on the quality of treatment in rheumatology - 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