Grant: Project Grant

One in a hundred Canadians live with rheumatoid arthritis (RA) and suffer 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. Early and appropriate treatment of RA has been shown to improve patient pain, function, disability, and survival. The Arthritis Alliance of Canada (AAC), representing over 36 organizations including patient organizations, healthcare provider groups, researchers and funding agencies has developed a set of performance measures to measure whether patients with RA are getting timely care and treated appropriately. These measures have been tested across Canada and a number of gaps in care have been identified including long waiting times for rheumatology consultations, lower than expected rates of treatment with disease-modifying anti-rheumatic drugs (the standard of care), and gaps in ongoing follow-up care. What is unknown is why these gaps occur and what this means for patients and the healthcare system. In the present study we will investigate in three Canadian provinces how better quality of care impacts patient outcomes and the healthcare system. While the measures have been nationally endorsed by the AAC, they are not routinely measured outside of a research context, as monitoring the quality of care in RA has not, to date, been a priority of provincial health organizations. The findings of our study will help solidify the importance of ongoing quality measurement for RA- one of the most expensive chronic diseases. Ultimately this work will instigate health systems to improve so that patients living with RA can get the best possible care and achieve the best possible health outcomes.