Allied Health in Rheumatology Triage Project (AHRT)

There is accumulating evidence that early treatment leads to better outcomes for patients with inflammatory arthritis (IA). Triage, which is the process of identifying the urgency of a patient's disease state efficiently and correctly, may facilitate early referral to a rheumatologist. Several studies have suggested that placing allied health professionals (occupational therapists, physical therapists, nurses, etc.) in a triage roll may reduce wait time for patients with suspected IA. The goal of this investigation will be to demonstrate the system-level impact of an Arthritis Society extended role occupational therapist (OT) or physical therapist (PT) working in a triage role in improving access to rheumatologists for people with IA. In this study two groups will be observed: intervention and "usual care" as determined by historical chart review. Wait times will be compared between both groups.

Study Overview

• Status: Completed
• Conditions: Inflammatory Arthritis
• Intervention / Treatment: Other: Therapist Triage

• Study Type: Interventional
• Enrollment (Actual): 295
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• New referrals from a GP
• Adults with possible IA (determined by rheumatologist through paper triage)

Exclusion Criteria:

• Currently on a disease-modifying antirheumatic drug (DMARD)
• Previously seen by a rheumatologist.
• FM, non-IA OA; soft tissue rheumatism; mechanical LBP

Study Plan

How is the study designed?

Design Details

• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Therapist Triage; All subjects in this group will be triaged by an extended role occupational or physical therapist prior to their visit with the rheumatologist.	Other: Therapist Triage; An extended role occupational or physical therapist will triage each subject in the study to determine the urgency of their case and how soon they need to see the rheumatologist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Time to first visit with the rheumatologist (wait time)	3 months

Secondary Outcome Measures

Outcome Measure	Time Frame
Time to diagnosis	3 months
Time to treatment (disease-modifying antirheumatic drug)	3 months

Collaborators and Investigators

• Sponsor: Sunnybrook Health Sciences Centre
• Collaborators: The Arthritis Society, Canada; Ontario Rheumatology Association; Ontario Best Practices Research Initiative

Study record dates

Study Major Dates

• Study Start: May 1, 2015
• Primary Completion (Actual): December 1, 2015
• Study Completion (Actual): December 1, 2015

Study Registration Dates

• First Submitted: June 4, 2015
• First Submitted That Met QC Criteria: June 4, 2015
• First Posted (Estimate): June 9, 2015

Study Record Updates

• Last Update Posted (Estimate): June 30, 2016
• Last Update Submitted That Met QC Criteria: June 29, 2016
• Last Verified: June 1, 2015

More Information

Terms related to this study

• Keywords: Psoriatic arthritis; Rheumatoid arthritis; Ankylosing spondylitis; Seronegative
• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Arthritis
• Other Study ID Numbers: AHRT-2015

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No