Testing of System-Level Performance Measures for Inflammatory Arthritis

Principal Investigator: Claire Barber MD PhD FRCPC Assistant Professor, Department of Medicine, Cumming School of Medicine, University of Calgary

Study start date: January 2015

Study end date: we anticipate that we will disseminate findings by summer 2017

Why do this research?

Over one million Canadians have inflammatory arthritis (IA). There are several types of IA all of which can cause debilitating pain and swelling of the joints. The most common type of IA in adults is rheumatoid arthritis (RA), and in children is juvenile idiopathic arthritis (JIA). Early access to appropriate treatment for patients with IA improves their outcomes e.g. a reduction in their symptoms or an improvement in their quality of life.

Rheumatologists are the specialist physicians who care for patients with IA. However, in many regions in Canada, high quality care provided in a timely manner is not possible because there is an insufficient number of rheumatologists. In response to this, the Arthritis Alliance of Canada (AAC), an organization representing over 36 Canadian arthritis stakeholder groups, developed ‘Models of Care for Inflammatory Arthritis’. The Models of Care promote best practices for early diagnosis and treatment for IA. In collaboration with arthritis stakeholders across Canada and the AAC, we have developed a set of performance measures to evaluate the Models of Care’s ability to provide access and timely treatment for patients with IA. Our results will contribute to the development of consistent measures of access to care and treatment across Canadian centers and to the advocacy for arthritis care in Canada.

What will be done?

In this study, we will evaluate 5 performance measures applied in 11 different clinical settings (different models of care and an early arthritis cohort) in 5 Canadian provinces.

We will report on the following measures:

  1. Waiting times for rheumatologist consultation
  2. Percentage of patients seen by a rheumatologist
  3. Percentage of patients seen in yearly follow-up by a rheumatology team member
  4. Percentage of RA patients treated with a disease modifying anti-rheumatic drug (DMARD)
  5. Time to DMARD therapy in RA

Who is funding the research?

The Canadian Initiative for Outcomes in Rheumatology Care (CIORA)


Diane Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia; Senior Scientist, Arthritis Research Canada

Cheryl Barnabe MD, MSc, FRCPC, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB

Deborah Marshall PhD, Professor, Arthur J.E. Child Chair in Rheumatology Research, Department of Community Health Sciences, Cumming School of Medicine, and Division of Rheumatology, Department of Medicine University of Calgary, McCaig Institute for Bone and Joint Health

Susanne Benseler MD, Section Chief Rheumatology, Department of Paediatrics, Alberta Children’s Hospital, Associate Professor, Department of Pediatrics, University of Calgary

Glen Hazlewood MD PhD FRCPC Assistant Professor, Department of Medicine, Cumming School of Medicine, University of Calgary

Dianne Mosher MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine University of Calgary

Vivian Bykerk MD FRCPC Hospital for Special Surgery, Weill Cornell University

Jennifer Burt PT, Rheumatology Services, St. Clare’s Mercy Hospital, Eastern Health, St. John’s, NL

Carter Thorne MD, FRCPC, Assistant Professor University of Toronto, Medical Director The Arthritis Program at Southlake Regional Health Centre, Newmarket

Vandana Ahluwalia MD, FRCPC, Corporate Chief of Rheumatology, William Osler Health System

Lisa Denning PT William Osler Health System

Natalie Shiff MD, Clinical Associate Professor, Department of Pediatrics, University of Florida Health

Steven Katz MD FRCPC, Associate Clinical Professor, University of Alberta

Joanne Homik MD FRCPC, Associate Professor, University of Alberta