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
Health Economics & Quality of Life (N Tsao, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Health Economics and Quality of Life


Purpose of the Review

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.

Recent Findings

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.


Inflammatory arthritis Multidisciplinary care Model of care Patient satisfaction Costs Health economics 



This work was supported by Canadian Institutes of Health Research (CIHR) Project grant no. 148842, (MH), The Arthritis Society—Strategic Operating grant 2016 (SOG-16-369) (MH) and Young Investigator Salary Award 2016 (YIS-16-104) (MH), and Michael Smith Foundation for Health Research Scholar Award 2017 (no. 16813) (MH).

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Harrison reports grants from Canadian Institutes of Health Research, grants from The Arthritis Society, and from Michael Smith Foundation for Health Research, during the conduct of the study.

Jill Hall, K. Julia Kaal, Junho Lee, Ross Duncan, and Nicole Tsao declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jill Hall
    • 1
  • K. Julia Kaal
    • 2
    • 3
  • Junho Lee
    • 2
  • Ross Duncan
    • 2
  • Nicole Tsao
    • 2
  • Mark Harrison
    • 2
    • 4
    • 5
  1. 1.Faculty of Pharmacy and Pharmaceutical Sciences, 3-236 Edmonton Clinic Health AcademyUniversity of AlbertaEdmontonCanada
  2. 2.Faculty of Pharmaceutical SciencesUniversity of British ColumbiaVancouverCanada
  3. 3.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  4. 4.Centre for Health Evaluation and Outcome Sciences, St Paul’s HospitalVancouverCanada
  5. 5.Arthritis Research CanadaRichmondCanada

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