About 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.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Patients of the Waterloo Rheumatology Community Clinic

Aged 18 to 80 years of age

Diagnosis of rheumatoid arthritis

Minimum of limited working proficiency in English

Disqualifiers

Age less than 18 years or greater than 80 years

Significant cognitive impairment that impedes ability to engage in the study

Unwilling to participate in the study

Patients currently pregnant will be excluded from the study

Trial design

Design model

Single group

Treatments tested in this trial

Primary Care Rheumatology Family Physician Consultation
Other intervention
The participant will be booked with a primary care rheumatology family physician for rheumatoid arthritis comorbidity screening. They will complete weight, height, blood pressure measurement, assess for risk factors for dyslipidemia, type 2 diabetes, hypertension, bone mineral density loss and vaccine preventable infectious diseases.

Treatment groups

199 Participants

are divided into 1 treatment group

Group A: Comprehensive Comorbidity ClinicExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Care Gap: Pneumococcal vaccination

the number of care gaps (percentage of individuals who require treatment according to established guidelines, but do not receive it) identified and addressed within 6 months of comorbidity clinic intervention, for pneumococcal vaccination.

Time frame

6 months

2

Care Gap: Cardiovascular screening

the number of care gaps (percentage of individuals who require treatment according to established guidelines, but do not receive it) identified and addressed within 6 months of comorbidity clinic intervention, for cardiovascular screening (determined by meeting a combination of blood pressure, cholesterol and blood sugar measurement guidelines)

Time frame

6 months

3

Care Gap: Osteoporosis screening

The number of care gaps (percentage of individuals who require treatment according to established guidelines, but do not receive it) for osteoporosis prevention and screening (determined by meeting guidelines for Vitamin D supplementation and bone densitometry completion)

Time frame

6 months

Secondary outcomes

1

Care Gap: vaccine-preventable diseases (herpes zoster, influenza and COVID-19)

the number of care gaps (percentage of individuals who require treatment according to established guidelines, but do not receive it) identified and managed for remaining vaccine-preventable diseases (herpes zoster, influenza and COVID-19).

Time frame

6 months

2

Care Gap: Comorbidity treatment with medication

(percentage of individuals who require treatment according to established guidelines, but do not receive it) identified and managed for the initiation of antihypertensive agents, cholesterol-lowering medications or medications for type 2 diabetes in study participants within the 6 months following the comprehensive comorbidity clinic.

Time frame

6 months

Comorbidity Management in Rheumatic Disease.

About this trial

Eligibility criteria

Qualifiers

Disqualifiers

Trial design

Treatments tested in this trial

Treatment groups

Trial outcomes

Primary outcomes

Secondary outcomes

Other outcomes

Sponsors and contacts