Family Physician Consultations for Rheumatoid Arthritis

Overseen By Cassandra Schulz, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Western University, Canada

Disqualifiers: Pregnancy, Cognitive impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

199 Participants Needed

Trial Summary

Do I need to stop my current medications for this trial?

The trial information does not specify if you need to stop your current medications. It seems the focus is on adding a family doctor to your care team, which might lead to changes in your treatment plan, but it's not clear if stopping medications is required.

What data supports the effectiveness of the treatment Primary Care Rheumatology Family Physician Consultation for Rheumatoid Arthritis?

The effectiveness of the Primary Care Rheumatology Family Physician Consultation is supported by research showing that good communication between primary care physicians and rheumatologists leads to high patient satisfaction and improved management of chronic diseases. Patients and general practitioners reported satisfaction with consultations, especially when communication was clear, even if major diagnostic changes were rare. ^{1 2 3 4 5}

Is the Family Physician Consultation for Rheumatoid Arthritis safe?

The research does not provide specific safety data for Family Physician Consultations for Rheumatoid Arthritis, but it highlights the importance of primary care physicians being aware of recommendations to monitor for adverse events in patients with rheumatologic diseases. ^{3 6 7 8 9}

How is the Primary Care Rheumatology Family Physician Consultation treatment different from other treatments for rheumatoid arthritis?

This treatment is unique because it emphasizes the role of family physicians in managing rheumatoid arthritis through improved communication and coordination with rheumatologists, which can enhance patient well-being and reduce costs by providing complementary therapies close to home. ^{3 8 10 11 12}

What is the purpose of this trial?

Rheumatoid arthritis is a disease where the immune system attacks the body by mistake, causing inflammation of the joints and other body parts. People with rheumatoid arthritis are at higher risk of infections, heart problems, and bone issues compared to others. They regularly see rheumatologists, arthritis care physicians, to manage their disease. However, managing these other health problems alongside their main treatment is difficult for rheumatologists due to limited resources. This clinical study is being conducted to see if adding a family doctor to a team of rheumatologists can help. Rheumatologists will complete a case report form about the patient's health and send them to a special family physician clinic. This clinic will focus on improving vaccination against diseases, heart health, and bone strength. They will check if patients need special vaccines to protect them from infections. They will screen for heart disease using blood pressure measurements, and order blood work for high cholesterol and diabetes if needed. They will also review bone health and send people for tests to check their bone density if needed. A change in routines and medications may be recommended after their checkup. Rheumatologists will complete another case report about the patient's health 6 months after their family doctor appointment. The study will assess how these markers of health management improve after this family doctor joins the team. It hopes to prove that this new way of working in the community will give people with rheumatoid arthritis better protection against certain infections, heart problems and weak bones.

Research Team

Cassandra Schulz

Principal Investigator

Western University

Eligibility Criteria

This trial is for people with rheumatoid arthritis, a condition where the immune system mistakenly attacks the body. Participants should be seeing a rheumatologist regularly and need help managing related health issues like infections, heart problems, and bone strength.

Inclusion Criteria

Participants will have a minimum of limited working proficiency in English and no significant cognitive impairment that can inhibit their ability to engage in the study

I am 18-80 years old with rheumatoid arthritis and a patient at the Waterloo Rheumatology Clinic.

Exclusion Criteria

Patients that are currently pregnant

I am able to understand and willing to participate in the study.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Comorbidity Clinic Intervention

Participants attend a comprehensive comorbidity clinic where they receive assessments and treatments for vaccinations, cardiovascular health, and bone health.

1 visit

1 visit (in-person)

Follow-up

Participants are monitored for improvements in health management markers, including vaccination status, cardiovascular health, and bone health.

6 months

Treatment Details

Interventions

• Primary Care Rheumatology Family Physician Consultation

Trial Overview The study tests if adding a family doctor to the patient's healthcare team improves management of comorbidities in rheumatic diseases. It involves special consultations focusing on vaccinations, heart health screenings, and bone density assessments.

Participant Groups

Group I: Comprehensive Comorbidity Clinic Experimental Treatment 1 Intervention

The following investigations and treatments will be offered as associated with a comprehensive comorbidity clinic appointment with the primary care rheumatology family physician: Blood pressure, heart rate, height and weight measurement. Blood work (standard lipid panel, fasting plasma glucose or glycated hemoglobin (A1C), eGFR, and Lipoprotein a, Bone densitometry (if applicable to the patient/participant). Vaccinations will be offered if applicable to the patient/participant according to Health Canada guidelines (Vaccination with Pneu-P-23, Pneu-C-13, herpes zoster and COVID-19 vaccine).

Who Is Running the Clinical Trial?

Western University, Canada

Lead Sponsor

Trials

270

Recruited

62,500+

Canadian Rheumatology Association (CIORA)

Collaborator

Trials

1

Recruited

200+

References

1. United States pubmed.ncbi.nlm.nih.gov

Identifying Content Themes in Primary Care Physician and Rheumatologist Communications Within Electronic Consultations: A Qualitative Study. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Referrals to a rheumatology unit: an evaluation of the views of patients, general practitioners, and consultants. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Quality and continuity of information between primary care physicians and rheumatologists. [2022]

4. Norway pubmed.ncbi.nlm.nih.gov

[Quality of an outpatient rheumatology clinic. Consumers' evaluation of medical aspects and service]. [2015]

5. Canada pubmed.ncbi.nlm.nih.gov

A rheumatology consultancy program with general practitioners in Catalonia, Spain. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Surveillance for and prevention of nonrheumatologic diseases in the patient with a rheumatologic diagnosis. [2010]

7. United States pubmed.ncbi.nlm.nih.gov

Medication risk communication during rheumatology office visits. [2015]

8. United States pubmed.ncbi.nlm.nih.gov

Provision of primary care by office-based rheumatologists: results from the National Ambulatory Medical Care Surveys, 1991-1995. [2018]

9. United States pubmed.ncbi.nlm.nih.gov

Relationships between knowledge and experience in the use of disease-modifying antirheumatic agents. A study of primary care practitioners. [2016]

10. Germany pubmed.ncbi.nlm.nih.gov

[The role of the family physician in cooperation and coordination management of chronic rheumatic patients]. [2006]

11. France pubmed.ncbi.nlm.nih.gov

Do primary care physicians have a place in the management of rheumatoid arthritis? [2020]

12. Canada pubmed.ncbi.nlm.nih.gov

Care partnerships between family physicians and rheumatologists. [2015]