Grant: Operating Grant

Rheumatic diseases are debilitating, painful, and incurable conditions that cause substantial illness, disability, excessive healthcare costs and poor quality of life. Osteoarthritis (OA), the most common rheumatic disease affects approximately 4 million Canadians (>10%). Any joint in the body may be affected and treatment and management varies by site (eg., hip, knee, hand). We will study a unique primary care research network - the Electronic Medical Record Administrative data Linked Database (EMRALD) - containing over 400,000 patients from over 350 family physicians across Ontario. The clinical data is also linked to administrative data (electronic codes for all healthcare encounters in the province). Our primary aim is to accurately identify all patients with OA within primary care EMRs - this will enable us to create the largest Canadian primary care OA cohort. We also aim to identify which joints are most commonly affected and the severity of OA. We will evaluate the quality of care and care patterns by family physicians (appropriate use of diagnostic tests and imaging, disease management), patient outcomes (chronic disease burden), and interactions with other healthcare providers (orthopedic surgeons, rheumatologists). We will assess variation in management (e.g., patient, physician, and practice-level factors) to inform models of care for OA and future interventions leveraging existing EMR infrastructure to reduce gaps in care. Our secondary aim is to accurately identify all Ontario patients with OA by using health administrative data to quantify the burden of OA by age, sex, and over time. Accurate data on disease burden and care patterns for OA are scarce, but critical in helping healthcare providers and decision makers to optimize clinical and public health strategies for disease management. By documenting disease burden, gaps in care, and patient outcomes, we can better inform an overall chronic disease management strategy.