Grant: CIHR Fellowship

Rheumatoid Arthritis (RA) is a chronic, inflammatory joint disease affecting 1% of adults. Left untreated, RA leads to diminished quality of life and disability. Several RA therapies are available and continue to emerge. Electronic health databases comprised of physician, hospitalization and prescription drug records are useful tools to conduct clinical research. They can be used to study treatment patterns and health outcomes, such as the development of co-morbidities and mortality over time. However, databases may differ, from one province to another, or from one country to another. As well, differences in study design (or in how data are collected and defined) may produce varying results when these databases are used for research. My aim is to standardize an approach for comparisons of RA patients across international health care databases, across Canada, the United States, and Sweden. Working with a knowledgeable international team, I will determine whether populations are similar in terms of demographics (age, gender), comorbidities (other conditions in addition to RA), and medication profiles. In addition, across settings, we will evaluate mortality, causes of death, and assess the influence of various factors contributing to pre-mature mortality in RA. By harmonizing methods by which databases can be used, we hope to improve the comparability and accuracy of future studies. Fostering international comparisons is a key element to further our understanding on how to optimally use these databases for research, so that we may optimize the health and well being of all those living with RA and other chronic conditions.