A Population‐Based Study Evaluating Retention in Rheumatology Care Among Patients With Rheumatoid Arthritis

• Published in: ACR open rheumatology 2022-07, Vol.4 (7), p.613-622
• Main Authors: Barber, Claire E. H., Lacaille, Diane, Croxford, Ruth, Barnabe, Cheryl, Marshall, Deborah A., Abrahamowicz, Michal, Xie, Hui, Avina‐Zubieta, J. Antonio, Esdaile, John M., Hazlewood, Glen, Faris, Peter, Katz, Steven, MacMullan, Paul, Mosher, Dianne, Widdifield, Jessica
• Format: Article
• Language: English
• Subjects: Age; Comorbidity; Datasets; Health insurance; Original; Patients; Personal health; Pharmacy; Population; Population-based studies; Retention; Rheumatoid arthritis; Rheumatology; Socioeconomic factors; Trends
• ISSN: 2578-5745; 2578-5745
• DOI: 10.1002/acr2.11442

Objective The study objective was to assess adherence to system‐level performance measures measuring retention in rheumatology care and disease modifying anti‐rheumatic drug (DMARD) treatment in rheumatoid arthritis (RA). Methods We used a validated health administrative data case definition to identify individuals with RA in Ontario, Canada, between 2002 and 2014 who had at least 5 years of potential follow‐up prior to 2019. During the first 5 years following diagnosis, we assessed whether patients were seen by a rheumatologist yearly and the proportion dispensed a DMARD yearly (in those aged ≥66 for whom medication data were available). Multivariable logistic regression analyses were used to estimate the odds of remaining under rheumatologist care. Results The cohort included 50,883 patients with RA (26.1% aged 66 years and older). Over half (57.7%) saw a rheumatologist yearly in all 5 years of follow‐up. Sharp declines in the percentage of patients with an annual visit were observed in each subsequent year after diagnosis, although a linear trend to improved retention in rheumatology care was seen over the study period (P