The primary goal of this study is to determine whether providing patient honoraria and/or outreach services can improve the attendance rate of appointments at an inner city rheumatology clinic in Vancouver, British Columbia.
The main question it aims to answer are:
* Does providing a financial honorarium ($20 for each follow-up appointment with completed bloodwork) improve attendance rate at an inner city rheumatology clinic? * Does providing a personalized outreach service for rheumatic diseases improve attendance rate at an inner city rheumatology clinic?
The researchers will compare providing patient honoraria to providing both honoraria and outreach services, and compare each of these to the regular appointment schedule without honoraria or outreach.
Participants will:
* Undergo randomization to receive honoraria or honoraria and outreach services together * Complete surveys about their health and understanding of their rheumatic disease at baseline, 3-month, and 6-month intervals * Visit the clinic every month for check-ups and monitoring bloodwork if they are started on immunosuppressants for their condition
Have a diagnosis of inflammatory arthritis secondary to an autoimmune rheumatic disease
Be attached to one of the Vancouver Coastal Health Community Health Centres for primary care
Be willing to attend in-person appointments at Pender Community Health Centre
Be at least 18 years of age and capable of consenting to participation
Have cognitive impairment or an untreated psychiatric condition that would severely impair ability to engage with outreach or treatment
Have no reasonably reliable method of contact (phone, email, social media, etc.)
Parallel
Honoraria
BehavioralA $20 honorarium for each appointment attended with completed bloodwork if requested.
Outreach
BehavioralA personalized outreach service specific for rheumatic disease.
Attendance at in-person follow-up appointments
Adherence to in-person follow-up measured by the ratio of appointments attended to appointments scheduled.
Clinical Disease Activity Index (CDAI)
The change in Clinical Disease Activity Index from baseline to 3-months and 6-months. The Clinical Disease Activity Index is a validated disease outcome measure in Inflammatory Arthritis ranging from 0 to 76. A higher score means a worse outcome.
Patient Qualitative Feedback
Patient qualitative feedback on the program via semi-structured interview.
Patient Reported Understanding of Disease and Medications
Patient Reported Understanding of Disease and Medications, as measured by likert scale at baseline, 3 months, and 6 months. The likert scale will range from 1 to 10, with higher scores indicating better understanding.
Patient reported pain related to arthritis
Patient reported pain related to arthritis on a visual analogue scale. The visual analogue scale is a validated measure of pain in arthritis, where participants are asked to indicate their severity of pain within the previous week on a 0 to 100mm score. A score of 0 indicates "no pain", and a score of 100 indicates "worst possible pain".
Tender Joint Count
Change in the number of tender joints as measured by their treating clinician on a 28-joint count basis.
Swollen joint count
Change in the number of swollen joints as measured by their treating clinician on a 28-joint count basis.
Number of Emergency Department Visits During the Study Period
Number of Emergency Department Visits During the Study Period
Number of Days in Hospital During the Study Period
Number of Days in Hospital During the Study Period
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University of British Columbia
Lead sponsor
Mary Pack Arthritis Center
Collaborator
This trial is not recruiting at the moment. You can still explore other options:
