Primary Care for Rheumatoid Arthritis
(TRAIN Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores whether primary care doctors can effectively manage rheumatoid arthritis (RA) instead of specialists. RA is a disease where the immune system attacks joints, causing pain and swelling. Participants will either continue seeing their rheumatologist or switch to a trained primary care provider. The trial focuses on people with stable RA living in northern New York who haven't changed their RA treatment in the last six months. The goal is to determine if care from a primary care provider can be a safe and convenient option for patients. As an unphased trial, this study offers patients the opportunity to contribute to research that could make RA care more accessible and convenient.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications. However, it requires that there have been no changes in your RA treatment for at least six months before joining the study.
What prior data suggests that this model is safe for RA patients?
Research has shown that treatments for rheumatoid arthritis (RA) in regular doctor's offices can be quite safe. Patients receiving standard RA treatments from their primary care doctor typically experience side effects similar to those seen when treated by specialists. For example, studies have found that some RA medications are well-tolerated, with side effects comparable to those of a placebo, which contains no active medicine. This study aims to determine if primary care doctors can safely manage RA treatment. In simple terms, the study examines whether visiting a regular doctor can be as safe and effective as seeing a specialist for RA care.12345
Why are researchers excited about this trial?
Researchers are excited about this trial because it explores a new way of managing rheumatoid arthritis (RA) by integrating primary care clinicians into the treatment process. Unlike the traditional model where RA care primarily occurs in a rheumatologist's office, this approach involves primary care providers who have been specially trained in RA management and collaborate closely with a rheumatology team. This could make RA care more accessible and personalized, potentially improving patient outcomes by providing consistent, coordinated care from a familiar healthcare provider.
What evidence suggests that this model is effective for rheumatoid arthritis?
This trial will compare the effectiveness of primary care and specialized rheumatology care for rheumatoid arthritis (RA). Research has shown that primary care can effectively treat RA. Studies have found that targeting low disease activity or remission improves outcomes for RA patients. Additionally, combining primary care with specialized treatments can help reduce disease activity and joint pain. Evidence suggests that with proper training, primary care doctors can manage RA as effectively as specialists. Furthermore, nurse-led care has proven to be just as effective as rheumatologist-led care in managing RA. These findings support the idea that well-trained primary care providers can successfully treat RA.678910
Who Is on the Research Team?
Eyal Kedar, MD
Principal Investigator
St. Lawrence Health
Are You a Good Fit for This Trial?
This trial is for individuals with stable Rheumatoid Arthritis, particularly those in rural areas like northern NY where access to specialists is limited. Participants will be randomly assigned to receive care from either a trained primary care provider or a rheumatologist.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Baseline Assessment
Initial data collection at baseline using standard assessments of RA activity
Treatment
Participants receive RA management from either trained PCPs or rheumatologists, with monthly case review sessions
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- Primary Care Treatment
Find a Clinic Near You
Who Is Running the Clinical Trial?
St. Lawrence Health System
Lead Sponsor