How Well Are We Treating Early Rheumatoid Arthritis in Canada?



Scientific Study Title:

Testing of System-Level Performance Measures for Inflammatory Arthritis


Study Start Date:


End Date:



Why Did We Do This Research?

The Arthritis Alliance of Canada (AAC) stresses the importance of a continuum of care, from early diagnosis to ongoing treatment in rheumatoid arthritis (RA) care. The AAC developed a way to test the success of care models, focusing on access to care and early treatment. This uses a set of quality measures. The goal was to check if the healthcare system is doing a good job in consistently providing care for people with early rheumatoid arthritis, making sure that they get the necessary treatments quickly.


What Did We Do?

We looked at patients who were part of the Canadian Early Arthritis Cohort (CATCH) from 2007 to 2015. We assessed 3 quality measures:

1. How regularly patients were followed up each year,
2. The use of medications known to slow down the disease’s progression, and
3. How quickly these medications were started after diagnosis.


What Did We Find?

The study included 1,763 patients, mostly middle-aged, mostly female, and largely white. The study found that:

• At first, all patients were seen yearly, but over eight years, this rate slightly dropped to 91%.
• About 42% of patients did not have any breaks in their care longer than 12 months, and 64% had no breaks longer than 14 months.
• A high percentage of patients were treated with disease-modifying antirheumatic drugs (DMARDs), which help to slow the disease’s progression. This rate slightly decreased from 95% to 87% over the study period.
• Most patients started taking DMARDs very quickly after their diagnosis, usually within a day. This showed that treatments were started quickly.

This study consists of 4 sub-projects dedicated to achieving our overall goals. Click below for more information about each sub-project:


Research Team

Principal Investigator:

Claire Barber, MD, PhD, FRCPC; Research Scientist, Arthritis Research Canada (University of Calgary)


Diane Lacaille, MD, FRCPC, MHSc, Scientific Director, Arthritis Research Canada (University of British Columbia)

Cheryl Barnabe, MD, MSc, FRCPC,  Senior Scientist, Arthritis Research Canada  (University of Calgary)

Deborah Marshall, PhD, Senior Scientist, Arthritis Research Canada (University of Calgary)

Susanne Benseler, MD, Research Scientist, Arthritis Research Canada (University of Calgary)

Glen Hazlewood, MD PhD FRCPC, Research Scientist, Arthritis Research Canada (University of Calgary)

Dianne Mosher (University of Calgary)

Vivian Bykerk  (Weill Cornell University)

Jennifer Burt (St. Clare’s Mercy Hospital)

Carter Thorne (University of Toronto),

Vandana Ahluwalia (William Osler Health System)

Lisa Denning (William Osler Health System)

Natalie Shiff (University of Florida Health)

Steven Katz (University of Alberta)

Joanne Homik (University of Alberta)



Who Funded the Research?

This study was funded by the Canadian Initiative for Outcomes in Rheumatology Care (CIORA).


Related Publication:

  • Barber CEH, Schieir O, Lacaille D, Marshall DA, Barnabe C, Hazlewood G, Thorne JC. Ahluwalia V, Bartlett SJ, Boire G, Haraoui B, Hitchon C, Keystone E, Tin D, Pope JE, Denning L, Bykerk VP, Canadian Early Arthritis Cohort Investigators (2018). High Adherence to System-Level Performance Measures for Rheumatoid Arthritis in a National Early Arthritis Cohort Over Eight Years. Arthritis care & research, 70(6), 842–850. https://doi.org/10.1002/acr.23439