Rheumatoid Arthritis Surveillance in Ontario: Monitoring the Burden, Quality of Care and Patient Outcomes through Linkage of Administrative Health Data

Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease.Using the Ontario administrative health data housed at the Institute for Clinical Evaluative Sciences, researchers have quantified the population-level burden and epidemiology of RA, mapped its geographic distribution in relation to rheumatologist supply, studied trends in access to rheumatology care and treatment and evaluated patient outcomes.The findings highlight the excess morbidity and mortality associated with the growing burden of RA in the face of a strained rheumatology supply, and raise urgent questions about how best to meet the needs of Ontarians with RA. The IssueGiven the rising levels of chronic disease and multimorbidity in Canada, researchers and decision-makers are increasingly looking to administrative health data as an information source for chronic disease detection and surveillance.Rheumatoid arthritis (RA) is just one condition for which administrative data-based research on disease burden, quality of care and patient outcomes is helping to transform the lives of Canadians with chronic disease.RA is the most common chronic inflammatory joint disease, affecting millions of people worldwide, and one of the most disabling and costly of all chronic diseases (Cross et al. 2014).At disease onset, RA is considered a medical emergency requiring prompt referral to a rheumatologist.To control symptoms and inhibit disease progression, treatment guidelines include disease-modifying antirheumatic drugs (DMARDs), biologic agents such as anti-tumour necrosis factor agents and corticosteroids (Bykerk et al. 2012).However, uncontrolled RA activity can lead to irreversible joint damage requiring surgery, multiple comorbidities and premature mortality.Many factors contribute to increased morbidity and mortality in patients with RA, including immune abnormalities, organ system manifestations associated with the disease, genetic predisposition, the immunosuppressive and cytotoxic effects of treatments and, possibly, poor quality of care.Here we highlight some recent Institute for Clinical Evaluative Sciences (ICES) research aimed at helping to improve the care and outcomes of patients with RA. Key Findings Optimizing Administrative Data AccuracyValidation of administrative data for identifying patients with various health states improves our understanding of when and how such data can be used for chronic disease surveillance and research.To assess the accuracy of administrative data for identifying RA patients, two independent validation studies were performed at ICES (Widdifield et al. 2013a(Widdifield et al. , 2014a)).This foundational work led to the establishment of the Ontario Rheumatoid Arthritis Database (ORAD), a validated, population-based registry.Derived by linking physician service claims,

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.