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Rheumatoid Arthritis Care in Alberta – ‘The right care at the right time by the right provider’

Scientific study title:

Development and pilot of a shared-care model for rheumatoid arthritis leveraging an “on-demand” follow-up strategy

Principal Investigator:

Claire Barber, MD, PhD, FRCPC, Associate Professor, Division of Rheumatology, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary and Research Scientist, Arthritis Research Canada Research Scientist, Arthritis Research Canada

Study Start Date:

July 2022

Study End Date:

July 2024

 

Why do this research?

Rheumatoid arthritis (RA) is a lifelong condition that needs ongoing monitoring. Follow-up appointments are scheduled every 6-12 months regardless of patient need. As a result, most rheumatology appointments are with people who have stable RA. This leaves less time to see patients with urgent concerns like flares. There are also shortages of rheumatologists which makes accessing care difficult. This has led to a system that cannot deliver the appropriate treatment when it is most needed and make sure it is delivered by the right health care provider.

We will create and test a different way of providing care. This will involve rheumatology healthcare providers, people with RA, and family doctors.

 

What will be done?

We aim to create and test a ‘patient-initiated’ model of delivering care. In this model, patients and/or family doctors arrange rheumatology care when needed.

First, we will develop the model in stages. We are exploring how many rheumatology visits could be done with a family doctor. Interviews will be done to understand barriers to providing this kind of care and what would make it successful. We will also create resources to support patients and family doctors who test the model.

Then, we will test the model with 50-75 adults with RA. Patients will see their family doctor for their RA for 1 year. Disease activity will be captured through questionnaires and bone imaging. Rheumatology care will be available if there is an urgent RA related concern such as a flare. At the end of the study, participants can share their experiences in an interview with the study team.

 

 

Who is involved?

Our study team/project stakeholders in Calgary, Alberta, will involve:

  • Patients
  • Rheumatology healthcare providers
  • Clinic/management staff from community and academic centers
  • Family doctors / primary care networks; and
  • The department of Radiology at the University of Calgary.

 

Co-Investigators

Alison Hoens, Knowledge Broker and Clinical Professor, Department of Physical Therapy, Faculty of Medicine, University of British Columbia ; Affiliate Knowledge Broker, Arthritis Research Canada
Sarah Manske, University of Calgary
Glen Hazlewood, University of Calgary
Rick Ward, MD, Family Physician
Diane Lacaille, Professor, Department of Medicine, University of British Columbia; Scientific Director, Arthritis Research Canada
Elena Lopatina, University of Calgary
Megan Barber, University of Calgary
Paul MacMullan, University of Calgary
Dianne Mosher, University of Calgary
Aurore Fifi-Mah, University of Calgary
Michelle Jung, Rheumatologist and clinical assistant professor in the Cumming School of Medicine in the Division of Rheumatology, University of Calgary
Leah Phillips, Alberta College of Family Physicians
Marinka Twilt, University of Calgary
Nadia Luca, Pediatric Rheumatologist. Alberta Children’s Hospital.
Karen Then, University of Calgary
Trafford Crump, University of Calgary
Kelly Osinski,RN, Alberta Health Services
Becky Job, Alberta Health Services,
Kiran Dhiman, Research Assistant, University of Calgary
Saania Zafar, Gurjeet Bhangu, Shakeel Subdar

 

Funding Agency

Canadian Initiative for Outcomes in Rheumatology Care (CIORA)

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