Comorbidity Management in Rheumatic Disease.

Western University, Canada

Status: Enrolling

Conditions: Comorbidities and Coexisting Conditions; Rheumatoid Arthritis

Treatments: Other: Primary Care Rheumatology Family Physician Consultation

Study type: Interventional

Funder types: Other

Identifiers

NCT06579222

125677

Details and patient eligibility

About

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.

Enrollment: 199 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 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
• No significant cognitive impairment that can inhibit their ability to engage in the study

Exclusion criteria

• 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

Primary purpose: Supportive Care

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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199 participants in 1 patient group

Comprehensive Comorbidity Clinic

Experimental group

Description:

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).

Treatment:

Other: Primary Care Rheumatology Family Physician Consultation