Rheumatologists’ Perceptions of Nurse-led Telephone Consultations for Patients with Rheumatoid Arthritis in Japan

OBJECTIVES: To examine rheumatologists' perceptions of nurse-led telephone consultations in rheumatoid arthritis patients, including differences in those working with and without rheumatology care nurses. METHODS: Rheumatologists completed a web-based questionnaire on nurse-led telephone consultations. RESULTS: 129 rheumatologists responded: 49 with rheumatology care nurses, 73 without, and 7 unknown. Regarding telephone consultations, 35.7% reported nurses handled them, and 34.9% either physicians or nurses did. Most agreed with nurse handling (87.6%) and its contribution to patient satisfaction (89.9%), with higher agreement among those with rheumatology care nurses (p< 0.001 both). High agreement was also observed for nurse management of daily life (93.0%), psychological issues (92.3%), and self-injection techniques (91.4%). Rheumatologists with rheumatology care nurses showed higher agreement across many items, including whether patients should self-inject biological agents (p = 0.001) and management of drug side effects (p = 0.011). Reported challenges included insufficient nurse knowledge and lack of reimbursement. Qualitative analysis indicated that nurse-led telephone consultations facilitate access, enable appropriate triage and prompt responses, and reduce unnecessary visits. Expected benefits included patient information gathering, clear explanations, psychological support, and complementing rheumatologists' work. CONCLUSIONS: Most rheumatologists agreed nurses handle telephone consultations, which were perceived to facilitate person-centered care, appropriate triage, and economic benefits.