Care for Rheumatoid Arthritis in British Columbia Study
The overall aims of our research are to evaluate the risks and benefits of biologics in RA; to evaluate the risk of and quality of care for selected co-morbidities linked to chronic inflammation in RA compared to the general population; and to evaluate the impact of an academic detailing intervention for family physicians on the quality of care for RA.
Specific objectives are:
1) To evaluate a) the risk, and b) the predictors, of adverse events, i.e. serious infections requiring hospitalization and malignancies, associated with exposure to the different classes of biologic agents, e.g. anti-TNF agents, abatacept, rituximab.
2) To evaluate whether use of biologics is associated with a reduction in risk of future RA joint surgery.
3) To evaluate a) the risk of co-morbidities linked to chronic inflammation, e.g. CVD, OP fractures, COPD, and diabetes, in RA compared to the general population; an b) the predictors of these co-morbidites in RA.
4) To assess the quality of care for primary and secondary prevention of co-morbidities in RA, e.g. CVD, infections, diabetes, OP fractures, compared to the general population.
5) To evaluate the effectiveness of an academic detailing intervention for family physicians at improving compliance with current RA treatment guidelines, by comparing the rate and timing of DMARD use and of referral to rheumatologists of RA patients followed by family physicians who have received our academic detailing intervention with that of patients seen by control physicians (who have received academic detailing from the provincial academic program on topics other than RA) and perform a cost-analysis of the intervention.