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Arthritis Research Canada at

CRA & AHPA Annual Scientific Meeting 2022

Research Spotlight

 

 

Characteristics of emergency department and urgent care centre use by patients with inflammatory arthritis conditions.

 

This research showed that patients with inflammatory arthritis (IA) in Alberta often had visits to emergency departments (EDs) or urgent care centres (UCC), suggesting that access to specialist(s) and primary care physicians does not meet their needs. In 2017, approximately ½ of patients with psoriatic arthritis and 1/3 of individuals with rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and gout accessed emergency services. Most visits occurred during daytime hours. The proportion of overall provincial emergency services that were for gout increased from 2.1% in fiscal year 2008-2009 to 3.6% in fiscal year 2017-2018.

 

Research Team: Barnabe C, McLane P, Holroyd B, Lang E, Luca N, Katz S, Homik J, Keeling S, McQuitty S, Davidson E, Lin K, Chomistek K, Elliott M, Hildebrandt C, Russon N, Stasiuk M, Barber C. Characteristics of emergency department and urgent care centre use by patients with inflammatory arthritis conditions.

 

To learn more about Arthritis Research Canada research presented at the CRA & AHPA Annual Scientific Meeting on February 3, please scroll down. We have research on COVID-19 and arthritis, rheumatoid arthritis, osteoarthritis, lupus, and much more.

Effectiveness of the Making it Work™ Program at Improving Absenteeism in Workers with Inflammatory Arthritis – Results of a Randomized Controlled Trial.

A randomized controlled trial evaluating the effectiveness of the Making it Work™ program found that, in addition to improving at-work productivity, the program was effective at reducing absenteeism by preventing sick days and work interruptions in workers with inflammatory arthritis across 3 Canadian provinces over 2 years. The program consists of 5 online modules, group meetings, ergonomic and vocational counselling and was designed to help workers with arthritis deal with employment issues.

Research Team: Luquini A, Zheng Y, Xie H, Backman C, Rogers P, Kwok A, Knight A, Gignac M, Mosher D, Li L, Esdaile J, Thorne C, Lacaille D.

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Work Disability and Function in Systematic Lupus Erythematosus (SLE): Early Results of an Exploratory National Study. 

This study looked at how lupus impacts work and showed that patients experience significant limitations in their ability to meet the demands of their work. Scores were comparable to a sample of patients diagnosed with cancer who returned to work for a least 12 hours per week. Quality of life was low, and rates of depression were high. Improved management of work disability and functional impairment is needed.

Research Team: Nowrouzi-Kia B, Avina-Zubieta JA, Fox M, Shaw W, H M, Haaland D, Pope J, Fortin PR, Bingham K, Rozenbojm N, Matsos M, Legault K, Tselios K, Peschken C, Su J, Reynolds J, Ivory C, Gladman D, Urowitz M, Sanchez-Guerrero J, Lim L, Keeling S, Katz P, Touma Z.

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Characteristics of emergency department and urgent care centre use by patients with inflammatory arthritis conditions. 

This research showed that patients with inflammatory arthritis (IA) in Alberta often had visits to emergency departments (EDs) or urgent care centres (UCC), suggesting that access to specialist(s) and primary care physicians does not meet their needs. In 2017, approximately 1/2 of patients with psoriatic arthritis and 1/3 of individuals with rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and gout accessed emergency services. Most visits occurred during daytime hours. The proportion of overall provincial emergency services that were for gout increased from 2.1 per cent in fiscal year 2008-2009 to 3.6 per cent in fiscal year 2017-2018.

Research Team: Barnabe C, McLane P, Holroyd B, Lang E, Luca N, Katz S, Homik J, Keeling S, McQuitty S, Davidson E, Lin K, Chomistek K, Elliott M, Hildebrandt C, Russon N, Stasiuk M, Barber C. Characteristics of emergency department and urgent care centre use by patients with inflammatory arthritis conditions.

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Does Patient Age Affect Surgical Appropriateness and Influence Surgeon Recommendations for Primary Total Knee Arthroplasty? A Cross-sectional Study of 2,037 Patients.

Younger individuals with knee osteoarthritis referred for knee replacement had similar or greater need for, and readiness or willingness to have surgery, as older individuals, but were at higher risk for complications. Incorporating a new tool that assesses appropriateness for surgery into decision-making about knee replacement surgery may help patients and clinicians consider the risks and benefits in a growing population of young individuals with knee osteoarthritis.

Research Team: Hawker G, Bohm E, Dunbar M, Jones A, Noseworthy T, Marshall D, BEST-Knee Study Team.

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“We don’t all speak with one voice”: A qualitative study exploring perceptions of including patient preferences in clinical trial design.

We interviewed patients and doctors to explore their thoughts on including patient preferences when designing clinical trials and found that including patient preferences when designing trials in rheumatology is important and could make trials more meaningful to patients.

Research Team: Thomas M, Marshall DA, Loyola Sanchez A, Bartlett SJ, Boonen A, Fraenkel L, Proulx L, Voshaar M, Bansback N, Buchbinder R, Guillemin F, Hiligsmann M, Richards DP, Richards P, Shea B, Tugwell P, Falahee M, Hazlewood G.

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Formulation of an Interdisciplinary Care Pathway for Early Rheumatoid Arthritis.

The ‘Calgary Early RA Care Pathway’ emphasizes a patient-centered and interdisciplinary approach to early RA identification and treatment. Implementation and evaluation of this care pathway is ongoing to support optimal care for patients.

Research Team: Gukova K, Barber CEB, Hazlewood G, Arbillaga H, MacMullan P, Zimmerman G, Barnabe C, Choi M, Barber M, Charlton A, Job B, Osinski K, Spencer N, Knott M, Pirani P.

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Productivity loss for parents of children with arthritis: The impact of disease activity status.

We examined the loss of productivity of parents who care for children with juvenile idiopathic arthritis (JIA) and explored the impact of the effect depending on whether the disease was active or inactive. We found that JIA results in socioeconomic burden to parents, including lost work days or low at-work productivity.  However, those effects were significantly lower in parents of children whose disease was inactive disease at the time.

Research Team: Grazziotin L, Marshall DA. 

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Decline in clinical severity of Paget’s disease of bone: Comparison between a contemporary cohort and a historical cohort 

In comparison to a historical cohort of patients with Paget’s disease, a disease of the bones, we observed that patients from our contemporary cohort, i.e. diagnosed after the year 2000, were older at the time of diagnosis, had mainly involvement of one bone area, rather than widespread bone involvement and had fewer complications of Paget’s such as fractures and bone deformities. This decline in clinical severity of Paget’s disease of the bones in Quebec is consistent with studies reported in other countries.

Research Team: Gendron E, Bouchard F, Singbo N, Brown JP, Michou L.

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Cost impact of switching to biosimilar infliximab and etanercept in British Columbia.

This study aims to understand the impact of the mandatory biosimilar switching policy on costs of prescription drugs. The findings suggest that the policy had a large impact on drug cost savings. Future work will explore if other cost categories were impacted.

Research Team: McClean AR, Law MR, Bansback N, Cheng L, Clement F, Tadrous M, Harrison M. 

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The Impact of Comorbidities on the Simple Disease Activity Index (SDAI) and its Components Over the First Year of Follow-up – An Analysis from the Canadian Early Arthritis Cohort (CATCH).

In this observational study of Canadian patients with early rheumatoid arthritis, having multiple other chronic conditions in addition to rheumatoid arthritis was associated with having more active arthritis, including a greater number of swollen joints, greater overall disease activity,  and less improvement from treatment. The results show that having other chronic diseases at the time of getting rheumatoid arthritis has a negative impact on RA and its evolution.

Research Team: Chen LR, Schier O, Valois MF, Pope J, Bartlett S, Boire g, Hazlewood g, Hitchon C, Keystone E, Tin D, Thorne C, Singbo N, Bykerk V, Bessette L, CATCH Canadian Early Arthritis Cohort (CATCH) Investigators.

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Help-seeking behaviors and treatment preferences for sleep problems among persons with inflammatory arthritis. 

Sleep disturbances, including difficulty initiating sleep, maintaining sleep, and/or early morning awakenings are common in persons with inflammatory arthritis and have been shown to contribute to worsening of symptoms including fatigue, pain, and health related quality of life. To guide the tailoring of an internet delivered cognitive behavioral therapy for persons with arthritis experiencing insomnia, an on-line needs assessment was conducted identifying help-seeking behaviors, insomnia management strategies and treatment preferences. The survey confirmed that people with insomnia are not getting the help they need and that people would be willing to use an internet program to improve sleep.

Research Team: McGuire D, Lacaille D, Savard S, Fortin P, Rahme E, Da Costa D.

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Do Risk-Taking Behaviours Predict COVID-19 Vaccine Acceptance in People With Rheumatic Disease?

People with rheumatic disease who are hesitant to get the COVID-19 vaccine are less likely to engage in risk-taking behaviours. Future research could focus on whether promotion of vaccine safety might increase vaccine uptake in this group.

Research Team: Valerio V, Rampakakis E, McDonald E, Bernatsky S, Hazel E, Colmegna I.

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Glucagon-like peptide 1 (GLP-1) receptor agonists in patients with obesity and rheumatoid or psoriatic arthritis: A scoping review. 

Glucagon-like peptide 1 receptor agonists are a new class of medications with established benefit for diabetes and for weight loss. Our review highlights additional promising anti-inflammatory effects potentially independent of weight loss. The effect of this class of medications on disease activity in patients with rheumatoid arthritis and psoriatic arthritis warrants further study.

Research Team: Karacabeyli D, Lacaille D.

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Multimorbidity Patterns and Associations with Disability Differ in Men and Women in the First Year following RA diagnosis: Results from the Canadian Early Arthritis Cohort (CATCH). 

Results from this large real-world incident cohort study suggest that people often have multiple other chronic conditions at the time of their RA diagnosis and the diseases they have differ between men and women. Results suggest potential shared risk factors and shared pathways between these disease and RA, and highlight the need to screen for and treat those other chronic conditions, particularly those which increase disability.

Research Team: Schieir S, Bartlett S, Valois MF, Hazlewood G, Bessette L, Hitchon C,  Edward Keystone Pope J, Tin D, Thorne C, Bykerk V, CATCH Canadian Early Arthritis Cohort (CATCH) Investigators.

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Predictors of health-related quality of life in rheumatoid arthritis patients.

This study evaluated the relative contribution of sociodemographic, rheumatoid arthritis-related, comorbidities, and lifestyle factors in predicting the health-related quality of life (HRQoL) of rheumatoid arthritis patients. Comorbidities (depression) contributed the most to predicting HRQoL, while lifestyle and sociodemographic factors contributed very little. HRQoL of the previous year contributed most to predicting future HRQoL.

Research Team: Hassen N, Zheng Y, Xie H, Khan K, Kopec J, Lacaille D.

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Increased risk of severe infections and mortality in patients with newly diagnosed anti-neutrophil cytoplasmic antibody–associated vasculitis: A population-based study.

We conducted a study of all patients with newly diagnosed anti-neutrophil cytoplasmic antibody–associated vasculitis (AAV) in British Columbia and found AAV is associated with s 3.8 fold increase in risk of infection and infection related mortality and a 3.2 fold greater total number of infections.

Research Team: Zhao K, Xie H, Esdaile J, Avina-Zubieta JA. 

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Beliefs and concerns about rheumatoid arthritis medications may predict influenza vaccine hesitancy: Results from the Canadian Early Arthritis Cohort (CATCH).

Using data from the Canadian Early Arthritis Cohort we found that flu vaccination rate is suboptimal in patients newly diagnosed with rheumatoid arthritis (RA), with 37% being vaccinated prior to diagnosis and 42% after diagnosis. People more likely to receive a flu shot included men, white racial background, not smoking, having higher beliefs about the importance of RA medications versus concerns about taking them, advanced therapeutics, and having a previous flu shot. Our work suggests that it is important to have conversations with new patients about their vaccination history and medication attitudes.

Research Team: Ta V, Schieir O, Valois MF, Colmegna I, Hitchon C, Bessette L, Hazlewood G, Thorne C, Pope J, Boire G, Tin D, Keystone E, Bykerk V, Bartlett S, and Canadian Early Arthritis Cohort (CATCH) Investigators.

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The relationship between disease activity measures and work productivity and activity impairment in patients with rheumatoid arthritis in the Rheum4U Precision Health Registry patient cohort.

People with rheumatoid arthritis who have more active inflammation have lower productivity at work and more impairment of their activities at home. Also people who were employed experienced more limitations at home than at work. The impact on work was driven by reduced productivity while at work more than by needing to take time off work.

Research Team: Marshall DA, Sandhu N, Benseler S, Twilt M, Guigue A, Gjata I, Stevenson M, Mosher D.

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Responsiveness of the CDAI When Scored with Patient-Reported vs. Clinician Assessed Joint Counts: Results from the Canadian Early Arthritis Cohort (CATCH) Study.

Results from this large observational study of people with rheumatoid arthritis suggest that disease activity measured using either a joint count derived from a rheumatologist joint exam or from a patient self-exam can pick up changes over time. This provides further evidence that patient reported assessment of disease activity can provide useful information about changes in patient disease control that can help inform treatment decision-making in virtual care.

Research Team: Bykerk V, Schieir O, Valois MF, Hazlewood G, Hitchon C, Boire G, Tin D, Bessette L, Keystone E, Carter T, Pope J, Bartlett S. CATCH Canadian Early Arthritis Cohort (CATCH) Investigators.

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Acceptability and Usability of the JIA Option Map, a Web-Based Patient Decision Aid for Pain Management in Juvenile Idiopathic Arthritis.

The JIA Option Map has good acceptability and usability, showing its potential to improve decision-making for pain management options among young people with Juvenile Inflammatory Arthritis. The next step will test the effectiveness of the app over time.

Research Team: Toupin-April K, Proulx L, Huber AM, Duffy CM, Couchman D, Morgan EM, Cohen JS, Gaboury I, Li LC, Trehan N, Sirois A, Sirotich E, Abrahams N, Houston A, Kashif I, Vij N, Stringer E, Cavallo S, Brinkman W, Connelly MA, Weiss JE, Gmuca S, Décary S, Tugwell P, Stinson J.

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Association of subjective cognitive report using PDQ-20 to a neuropsychological battery in a cohort of SLE patients.

Systemic Lupus Erythematosus (SLE) can lead to a number of neuropsychiatric manifestations including impairment in cognition. The most accurate way of measuring this is through a comprehensive battery of neuropsychological tests administered in person. However, such testing is very cumbersome for research purposes. This study aimed to compare a subjective questionnaire, the perceived deficits questionnaire (PDQ-20) to results from the in-person battery of tests, and to other patient reported outcomes. Self-reported cognitive function using the PDQ-20 was associated with cognitive impairment measured by the in-person testing when the two were directly compared, but not once other factors that influence cognitive function were controlled for. Self-reported cognitive function was associated with emotional health, and with other patient reported outcomes, such as SLE severity, fatigue, depression and anxiety.

Research Team: Gupta A, Johnson S, Su J, Knight A, Diaz-Martinez J, Bingham K, Tartaglia C, Ruttan L, Wither J, Choi M, Fritzler M, Bonilla D, Beaton D, Katz P, Green R, Touma Z.

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