A Shared-Care Model for Rheumatoid Arthritis Leveraging an “On Demand” Follow-Up Strategy

A patient-initiated model of delivering care for people with rheumatoid arthritis.

The Problem

Rheumatoid arthritis is a lifelong disease that needs ongoing monitoring. Rheumatologist follow-up appointments are scheduled at fixed intervals for convenience, leaving little time for last minute appointments at times of urgent need, this is made even more difficult by the shortage of rheumatologists.

The Solution

Alternative ways of delivering care are needed, that better meet patients’ needs, and that ensure patients are seen by the right healthcare provider, at the time they need it most.


What the Study will do

This study aims to create and test a ‘patient-initiated’ model of delivering care where patients will be followed by their family doctor when their disease is stable, and arrange rheumatology follow-up visits when needed, rather than at fixed pre-determined intervals.

The Research Study

This study will involve people living with rheumatoid arthritis (RA), rheumatology healthcare providers, and family doctors to create and test a ‘patient-initiated’ model of delivering rheumatology care.

First, there will be a review of patients charts to determine which patients and how many rheumatology follow-up visits could have been done with a family doctor. Interviews will be conducted with patients and physicians to understand barriers to providing this kind of care and what would make it successful. The study will also create resources to support patients and family doctors when testing the new model.

Then, the model will be tested by 50 to 75 adults with RA. Patients with stable disease will see their family doctor for their RA for one year. Disease activity will be captured through questionnaires and state of the art joint imaging will assess whether adverse impact on joints occurs. Rheumatology care will be available rapidly as needed if there is an urgent concern related to RA or treatment, such as a flare or side-effect of medication. At the end of the study, participants will share their experiences in an interview with the study team.

Research Scientist

Claire Barber, Rheumatology, MD, PhD, FRCPC

Claire Barber, Rheumatology, MD, PhD, FRCPC

Research Scientist

Dr. Barber completed an honors degree in microbiology and immunology (2002), a medical degree (2006), and internal medicine training (2009) at Dalhousie University in Halifax, Nova Scotia. She then pursued subspecialty medical training in rheumatology at the University of Toronto (2011). She came to Calgary to pursue additional research training in epidemiology and graduated with a PhD in Epidemiology from the Department of Community Health Sciences at the University of Calgary in 2016.

Currently, Dr. Barber is an Associate Professor in the Departments of Medicine and Community Health Sciences at the Cumming School of Medicine, University of Calgary since 2015. She is also affiliated with the O’Brien Institute for Public Health and the McCaig Institute for Bone and Joint Health. She is the current Scientific Director of the Bone and Joint Health Strategic Clinical Network for Alberta Health Services.

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