Benefit of health education by a training nurse in patients with axial and/or peripheral psoriatic arthritis: A systematic literature review

The aim of this study was to systematically review the literature available about the benefit of health education by a training nurse in patients with axial and/or peripheral psoriatic arthritis in the framework of the drawing up of the axial spondyloarthritis and psoriatic arthritis guidelines of the Spanish Society of Rheumatology. Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, Medline/PubMed, CINAHL) were systematically searched from inception to 2014 using medical subject headings and keywords. Only articles in English, Spanish and French were included. The patients studied had to be diagnosed of psoriatic arthritis (all ages, both sexes) with axial involvement and/or peripheral arthritis who had received health education by a specialized nurse. We included in the search randomized clinical trials, cohort observational studies, descriptive studies and case series and qualitative research studies. Measured outcomes were those related to the education provided in a nursing consultation such as increased adherence to biological therapy, conducting exercises, smoking cessation and patient satisfaction. Eight studies were included, five randomized clinical trials with moderate level of quality and three intervention studies with no control group with low level of quality. Meta-analyses were not undertaken due to clinical heterogeneity. According to our results, it can be concluded that although there is little evidence on the role of a trained nurse in patients with psoriatic arthritis, this role can be beneficial to the patients because it can increase the rate of adherence to treatment prescribed by a rheumatologist, promotes patient self-management of their disease and increases patient satisfaction.