Improving referrals to rheumatologists for patients with inflammatory arthritis
department or school: Medicine, Faculty of
department or school: Population and Public Health (SPPH), School of
data provider: DSpace
degree campus: UBCV
creator: Biln, Norma Kor
issued: 2024-08-06T19:25:56Z
issued: 2024
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: Background: There are two broad types of arthritis, and patient care differs by type. Those with inflammatory arthritis (IA) should be treated by a rheumatologist within 12 weeks of symptom onset, while those with non-IA, can benefit from multi-disciplinary care and lifestyle modifications. No standard referral tools are used to help primary care physicians (PCP) direct people with joint pain to the appropriate healthcare provider. Many patients wait needlessly, sometimes in the wrong queue, increasing their chances of disability. Objectives: First, to understand recent trends in patient referrals to rheumatologists in British Columbia (BC). Second, to identify and test the accuracy of a patient-completed questionnaire to classify and prioritize patients with IA for referral from primary care to rheumatologists and seek the perspectives of patients and rheumatologists for implementation considerations. Methods: Using administrative databases from Population Data BC, current rheumatology referrals trends were examined. A scoping review was performed to identify validated questionnaire(s) to evaluate in a BC clinical study: The Patient Self-Administered Inflammatory Arthritis Detection (SAID) study. A multi- and mixed methods approach was used to gain user perspectives of barriers and opportunities to implement a questionnaire in the referral pathway. Results: Rheumatology referral trends in BC showed long wait times for patients with IA and a high proportion of referral of patients with non-IA. Access improved between 2010-2020 but remained long, particularly for females and people living outside of metropolitan areas. The scoping review identified 53 studies of referral tools. Two tools were selected for The Patient SAID Study; the Early Inflammatory Arthritis Questionnaire (EIAQ) and the Case Finding Axial Spondyloarthritis (CaFaSpa) questionnaire. The reported EIAQ performance was not replicated, but a new, preliminary scoring algorithm, that added a back pain que…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/88878
note: IMPROVING REFERRALS TO RHEUMATOLOGISTS FOR PATIENTS WITH INFLAMMATORY ARTHRITIS by Norma Kor Biln BSc., McGill University, 1993 MBA, University of Phoenix, 2001 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Population and Public Health) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) July 2024 © Norma Kor Biln, 2024 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: Improving referrals to rheumatologists for patients with inflammatory arthritis submitted by Norma Kor Biln in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Population and Public Health Examining Committee: Mark Harrison, Associate Professor, Faculty of Pharmaceutical Sciences, UBC Co-supervisor Nick Bansback, Professor, Faculty of Medicine, School of Population and Public Health, UBC Co-supervisor Kam Shojania, Professor, Faculty of Medicine, Division of Rheumatology, UBC Supervisory Committee Member Mary De Vera, Associate Professor, Faculty of Pharmaceutical Sciences, UBC University Examiner Antonio Avina-Zubieta, Associate Professor, Faculty of Medicine, Division of Rheumatology, UBC University Examiner Additional Supervisory Committee Members: Charlyn Black, Professor, Faculty of Medicine, School of Population and Public Health, UBC Supervisory Committee Member iii Abstract Background: There are two broad types of arthritis, and patient care differs by type. Those with inflammatory arthritis (IA) should be treated by a rheumatologist within 12 weeks of symptom onset, while those with non-IA, can benefit from multi-disciplinary care and lifestyle modifications. No standard referral tools are used to help primary care physicians (PCP) direct people with joint pain to the appropriate healthcare provider. Many patients wait needlessly, sometimes in …
has type: Thesis/Dissertation
date issued: 2024-11
is shown at: 10.14288/1.0444997
language: eng
degree discipline: Population and Public Health
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Harrison, Mark (Assistant professor)
contributor: Bansback, Nick
type: Text
identifier URI: http://hdl.handle.net/2429/88878