Electronic and Lab Pre-screening of New Rheumatology Patients With Rheumatoid Arthritis

• Conditions: Rheumatoid Arthritis; Inflammatory Arthritis

• Registration Number: NCT03843619
• Lead Sponsor: Arthritis Northwest PLLC

Brief Summary

By forming the foundation of a delivery system that integrates primary care (PC) and rheumatology, this initiative strives to strengthen the roles of both primary care and rheumatology practices as they co-manage patients in a quality care delivery system. Importantly, it strives to fill an unmet need, the rapid evaluation by Primary Care providers; the appropriate and timely referral of inflammatory disease patients to a rheumatologist; and the implementation of early aggressive therapy in the management of patients with rheumatoid arthritis (RA) with tight control. Given the call for improved quality, value, and demonstration of results\[1\], this initiative uses the tenets of National Center for Quality Assurance's Patient Centered Specialty Program\[1\] (PCSP) and it successfully masters and streamlines coordination of care.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2019-01-22
• Status Verified: 2019-02
• Study First Submitted QC: 2019-02-14
• Last Update Submitted: 2019-02-14
• Study First Posted: 2019-02-18
• Last Update Posted: 2019-02-18
• Study Start: 2019-02-28
• Primary Completion: 2022-03-31
• Study Completion: 2022-03-31

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 200

Inclusion Criteria

• First ever referral to a rheumatologist.

Exclusion Criteria

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To increase referral efficiencies through an electronic system to decrease the timeline prior	One year enrollment period	Mean and median time (in days) to the first rheumatology visit from PCP referral for both cohorts

Secondary Outcome Measures

Name	Time	Method
To assess difference in disease activity progression using Clinical Disease Activity Index (CDAI) at both 12 and 24 months.	One year enrollment period with two year follow-up period.	The change in CDAI score from baseline at 1 and 2 years. CDAI uses a scale of 0 - 60 where scores less than 2.8 are considered "remission", 2.9 - 10.0 are "low" disease activity, 10.1 - 22.0 are "moderate" disease activity, and 22.1 or higher are "high" disease activity.
To assess difference in disease activity progression using Routine Assessment of Patient Index Data (RAPID3) at both 12 and 24 months.	One year enrollment period with two year follow-up period.	The change in RAPID3 score from baseline at 1 and 2 years. RAPID3 uses a scale of 0 - 30 where scores less than 3.1 are considered "remission", 3.1 - 6.0 are "low" disease activity, 6.1 - 12.0 are "moderate" disease activity, and 12.1 or higher are "high" disease activity.
To assess radiographic progression using sharp scores in the electronically referred cohorts versus the traditional cohort.	One year enrollment period with two year follow-up period.	The change in sharp scores from baseline at 1 and 2 years.