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Study reveals bottlenecks that harm the quality of care provided to individuals with arthritis.
Posted On: January 02, 2017
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It is estimated that 65% of Canadians over the age of 65 suffer from debilitating hip- and/or knee-related osteoarthritis.
Although “arthritis” is a commonly used term there is much less public awareness that there are two major types of arthritis. Osteoarthritis, the most common type, typically progresses with age through a series of stages that lead to pain and reduced joint flexibility and may eventually require joint replacement surgery. Inflammatory arthritis, such as rheumatoid arthritis, typically begins at younger ages and requires more aggressive medical treatment in the early stages.
TRI Senior Scientist Dr. Cheryl Cott and a research team from Ontario, Alberta and British Columbia, interviewed health care professionals in three provinces to identify strategies currently being used to improve timely arthritis care. They found that irrespective of the type of arthritis, patients require a referral from their family physician to a specialist such as a rheumatologist or orthopaedic surgeon in order to obtain treatment. However patients often experience delays in seeing a specialist particularly for joint replacement surgery. Delays are also a major concern for inflammatory arthritis as aggressive early intervention is known to slow disease progression.
A lack of arthritis health care providers and specialists, particularly in rural and remote areas, make delivering timely services challenging in Canada. The researchers found many local examples of attempts to improve timely service delivery such as standardizing referrals from family physicians to specialists and using non-specialist health care providers to screen referrals to identify patients requiring urgent care.
The research team also discovered that there is a disproportionate focus in current services on managing the early stages of inflammatory arthritis and late stages of osteoarthritis, perhaps due to the existence of medical and surgical interventions for these stages of disease. In contrast, individuals with mid-stage arthritis (a group that actually comprises the largest number of people with arthritis) have limited care options and must rely on the haphazard availability of community-based services.
“Our study has identified a large patient population that is not receiving timely or sufficient care.” explains Dr. Cott. “It highlights the need to develop and implement models of care that consider these patients while keeping in mind that funding and staffing resources might be limited in certain communities.“
This work was supported by the Canadian Institutes of Health Research and the Toronto Rehab Foundation.
Commonalities and differences in the implementation of models of care for arthritis: key informant interviews from Canada. Cott CA, Davis AM, Badley EM, Wong R, Canizares M, Li LC, Jones A, Brooks S, Ahlwalia V, Hawker G, Jaglal S, Landry M, MacKay C, Mosher D. BMC Health Services Research. 2016 Aug 19. doi:10.1186/s12913-016-1634-9. [PubMed abstract]
TRI Senior Scientist Dr. Cheryl Cott and a research team from Ontario, Alberta and British Columbia, interviewed health care professionals in three provinces to identify strategies currently being used to improve timely arthritis care. They found that irrespective of the type of arthritis, patients require a referral from their family physician to a specialist such as a rheumatologist or orthopaedic surgeon in order to obtain treatment. However patients often experience delays in seeing a specialist particularly for joint replacement surgery. Delays are also a major concern for inflammatory arthritis as aggressive early intervention is known to slow disease progression.
A lack of arthritis health care providers and specialists, particularly in rural and remote areas, make delivering timely services challenging in Canada. The researchers found many local examples of attempts to improve timely service delivery such as standardizing referrals from family physicians to specialists and using non-specialist health care providers to screen referrals to identify patients requiring urgent care.
The research team also discovered that there is a disproportionate focus in current services on managing the early stages of inflammatory arthritis and late stages of osteoarthritis, perhaps due to the existence of medical and surgical interventions for these stages of disease. In contrast, individuals with mid-stage arthritis (a group that actually comprises the largest number of people with arthritis) have limited care options and must rely on the haphazard availability of community-based services.
“Our study has identified a large patient population that is not receiving timely or sufficient care.” explains Dr. Cott. “It highlights the need to develop and implement models of care that consider these patients while keeping in mind that funding and staffing resources might be limited in certain communities.“
This work was supported by the Canadian Institutes of Health Research and the Toronto Rehab Foundation.
Commonalities and differences in the implementation of models of care for arthritis: key informant interviews from Canada. Cott CA, Davis AM, Badley EM, Wong R, Canizares M, Li LC, Jones A, Brooks S, Ahlwalia V, Hawker G, Jaglal S, Landry M, MacKay C, Mosher D. BMC Health Services Research. 2016 Aug 19. doi:10.1186/s12913-016-1634-9. [PubMed abstract]