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Ontarians suffering from rheumatoid arthritis not receiving the speciality care they need

Nearly 60 per cent of Ontarians with rheumatoid arthritis — an autoimmune disease that causes chronic inflammation of the joints — were not seen by a specialist within a one year period to treat the debilitating disease, according to a new study.

Toronto, July 6, 2010

POWER Study Cover of the POWER Study chapter on Musculoskeletal Disorders. Download full chapter or highlights document at powerstudy.ca.

Even more concerning is that women of child-bearing age are less likely to see a specialist than women 45 or older, say researchers from St. Michael’s Hospital, the Institute for Clinical and Evaluative Sciences (ICES), and Women’s College Hospital.

“People think the aches and pains associated with arthritis are a normal part of aging, leading to delays in seeking care,” says Dr. Gillian Hawker, adjunct scientist at ICES and lead author of the latest chapter of the Project for an Ontario Women’s Health Evidence-Based Report (POWER) study. “But we know early diagnosis and treatment, especially within the first three to six months, is critical to preventing the long-term disability caused by rheumatoid arthritis.”

In Ontario, an estimated 55,000 women and 22,000 men have been diagnosed with rheumatoid arthritis, with women twice as likely to be affected as men.

“Unfortunately, only 42 per cent of women with rheumatoid arthritis in Ontario see specialists each year," says Dr. Arlene Bierman, a physician at St. Michael’s Hospital and principal investigator of the POWER Study. “Low income women are less likely to have seen a specialist than those with higher incomes and a person’s likelihood of seeing a specialist depends on where they live in the province. Access to these services is important and there is much that can be done to improve this access through innovations in how we organize and deliver care for chronic disease.”

Studies show that primary care physicians may fail to refer patients to specialists because they lack confidence in performing the joint exams necessary to identify and diagnose inflammatory arthritis. And with a limited number of arthritis specialists — only 350 in Canada – including some who are strictly academics and don’t see patients, access to speciality care may be limited.

The joint study between St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences (ICES) – is the first in the province to provide a comprehensive overview of women’s health in relation to gender, income, education, ethnicity and geography. Funded by Echo: Improving Women’s Health in Ontario, an agency of the Ontario Ministry of Health and Long-Term Care, the results from the POWER Study are available for policymakers and health-care providers to improve access, quality and outcomes of care for Ontario women.