Understanding how quality of care affects rheumatoid arthritis outcomes


Scientific Study Title: 

Understanding the effect of adherence to system-level performance measures on outcomes for rheumatoid arthritis 


Principal Investigators:         

Claire Barber, MD, PhD, FRCPC, (Nominated Principal Investigator), Assistant Professor, Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary


Diane Lacaille, MD, MHSc, FRCPC, Principal Investigator, Professor, Department of Medicine, Division of Rheumatology, University of British Columbia


Jessica Widdifield, BSc, PhD, Principal Investigator, Assistant professor, Institute of Health Policy, Management and Evaluation, University of Toronto


Study Start Date: 


Study End Date: 



Why do this research? 


One in a hundred Canadians lives with rheumatoid arthritis (RA) and suffers daily joint swelling, stiffness and pain. RA causes disability and sometimes can lead to joint replacement surgery if not properly treated. Joint inflammation in RA also increases the risk of heart attacks and strokes. These complications of chronic inflammation contribute to substantial disability, increased healthcare costs and premature deaths. Studies show early and appropriate treatment of RA improve patient pain, function, disability, and survival.


The Arthritis Alliance of Canada (AAC) developed a national set of performance indicators to measure whether patients with RA are getting timely care and treated appropriately. Testing of these measures across Canada identified gaps in care including long waiting times for rheumatology consultations, lower than expected rates of treatment with disease-modifying anti-rheumatic drugs (the standard of care), and inconsistent follow-up care. It is unknown why these gaps occur and what they mean for patients and the healthcare system.


What will be done?

In this study we will use administrative data from 3 Canadian provinces, Alberta, British Columbia and Ontario to investigate how quality of care, as measured by the AAC performance measures, affects patient outcomes and the healthcare system.


Who is involved? 

The team includes practicing rheumatologists, and experts in quality of care research, health economics, and statistics. 



Michal Abrahamowicz PhD (McGill)

Antonio Avina-Zubieta MD, MSc, PhD FRCPC (UBC)

Cheryl Barnabe MD, MSc, FRCPC, (UCalgary)

John Esdaile MD, MPH, FRCPC, FCAHS (UBC)

Peter Faris PhD (UCalgary)

Glen Hazlewood, MD, PhD, FRCPC (UCalgary)

Steven Katz, PhD (UAlberta)

Paul MacMullan MD (UCalgary)

Deborah Marshall, PhD (UCalgary)

Dianne Mosher MD (UCalgary)

Hui Xie, MS, PhD (SFU)

Research Staff:

Nicole Spencer, MSc (UCalgary)

Funding Agency

Canadian Institutes of Health Research