Self-assessment Triage in Inflammatory Arthritis

Sunnybrook Health Sciences Centre

Status: Unknown

Conditions: Inflammatory Arthritis

Treatments: Other: Self-administered Triage

Study type: Interventional

Funder types: Other

Identifiers

NCT04956380

261-2017

Details and patient eligibility

About

There are benefits to early, intensive treatment of IA. But getting to treatment depends on timeline and accurate case identification. The longest delays occur in persons self-identifying the need to see care for IA, recognition of these cases by primary care providers (PCPs), and appropriate, timely referral to rheumatology. Current methods of improving time to referral and consultation are effective, but costly and unsustainable, so there is need to look for alternatives. One solutions may be the use of patient self-administered tools.

In this study, we will test whether the use of validated, self-administered patient questionnaires (self-assessment) can advance the urgency rating of referrals for people with inflammatory arthritis (IA). If urgency ratings can be advanced then self-assessment may have the potential to reduce wait times to see a rheumatologist.

In Canada, one in every hundred people has IA and hundreds of new patients are diagnosed each year. Wait times to see a rheumatologist are long, so anything that has the potential to reduce these wait times would have a significant impact.

Enrollment: 207 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• new patient referral

Exclusion criteria

• under 18 years of age
• confirmed diagnosis of inflammatory condition
• seen/managed by another rheumatologist within the last five years
• unable to speak English
• on disease modifying antirheumatic drugs.
• referrals from the Emergency Department

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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207 participants in 4 patient groups

Joint Count + Early Inflammatory Arthritis Detection Tool

Experimental group

Description:

Rheumatologist reviews both the self-administered tender joint count (out of 68 joints on a homunculus) and self-administered Early Inflammatory Arthritis Detection Tool that were completed by the patient. Rheumatologist then uses the information provided in these tools by the patient to determine whether they should advance the urgency rating of the case.

Treatment:

Other: Self-administered Triage

Early Inflammatory Arthritis Detection Tool

Experimental group

Description:

Rheumatologist reviews both the self-administered Early Inflammatory Arthritis Detection Tool that was completed by the patient. Rheumatologist then uses the information provided in this tool by the patient to determine whether they should advance the urgency rating of the case.

Treatment:

Other: Self-administered Triage

Joint Count

Experimental group

Description:

Rheumatologist reviews both the self-administered Patient Tender Joint Count that was completed by the patient. Rheumatologist then uses the information provided in this tool by the patient to determine whether they should advance the urgency rating of the case.

Treatment:

Other: Self-administered Triage

Control

No Intervention group

Description:

Rheumatologist does not review any of the self-administered tools completed by the patient.