Care for Rheumatoid Arthritis in British Columbia Study

Project number: 
14-131
Approval date: 
Monday, February 1, 2016
Principal Investigator: 
Lacaille,Diane
Institution: 
Arthritis Research Centre of Canada
Funding Agency: 
Canadian Institutes of Health Research(CIHR)
Datasets requested: 
Consolidation registry (Ministry of Health)
Medical Services Plan (BC Ministry of Health)
Deaths (BC Vital Statistics Agency)
Hospital Separations (BC Ministry of Health)
consolidation - census geocodes
LifeLabs
Income band (Statistics Canada)
PharmaCare (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
PharmaNet
bc cancer
Research objective: 

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.

Publications: 

Journal Publication

  • Schmidt TJ, Avina-Zubieta JA, Sayre EC, Abrahamowicz M, Esdaile JM, Lacaille D. Quality of Care for Cardiovascular Disease Prevention in rheumatoid arthritis: Compliance Lipid Screening Guidelines. Rheumatology (Oxford). 2018 Oct 1;57(10):1789-1794. doi: 10.1093/rheumatology/key164.
  • Schmidt TJ, Avina-Zubieta JA, Sayre EC, Abrahamowicz M, Esdaile JM, Lacaille D. Cardiovascular Disease Prevention in rheumatoid arthritis: Compliance with Diabetes Screening Guidelines. J Rheumatol. 2018 Oct;45(10):1367-1374. doi: 10.3899/jrheum.170973. Epub 2018 Jul 15.
  • McGuire K, Aviña-Zubieta JA, Esdaile JM, Sadatsafavi M, Sayre EC, Abrahamowicz M, Lacaille D. Risk of Incident Chronic Obstructive Pulmonary Disease (COPD) in Rheumatoid Arthritis: A Population Based Cohort Study. Arthritis Care Res (Hoboken). 2017 Oct 19. doi: 10.1002/acr.23410.
  • Lacaille D, Avina-Zubieta JA, Sayre EC, Abrahamowicz M
    Improvement in 5-year mortality in incident rheumatoid arthritis compared with the general population—closing the mortality gap. Annals of the Rheumatic Diseases 2017;76:1057-1063.

Page last revised: September 2, 2019