Priorities for High-quality Care in Rheumatoid Arthritis: Results of Patient, Health Professional, and Policy Maker Perspectives

Claire E H Barber; Diane Lacaille; Marc Hall; Victoria Bohm; Linda C Li; Cheryl Barnabe; Glen S Hazlewood; Deborah A Marshall; James A Rankin; Karen Tsui; Kelly English; Paul MacMullan; Joanne Homik; Dianne Mosher; Karen L Then

doi:10.3899/jrheum.201044

Priorities for High-quality Care in Rheumatoid Arthritis: Results of Patient, Health Professional, and Policy Maker Perspectives

J Rheumatol. 2021 Apr;48(4):486-494. doi: 10.3899/jrheum.201044. Epub 2020 Nov 15.

Authors

Claire E H Barber¹, Diane Lacaille², Marc Hall³, Victoria Bohm⁴, Linda C Li⁵, Cheryl Barnabe⁶, Glen S Hazlewood⁷, Deborah A Marshall⁸, James A Rankin³, Karen Tsui⁹, Kelly English⁹, Paul MacMullan⁴, Joanne Homik¹⁰, Dianne Mosher⁴, Karen L Then³

Affiliations

¹ C.E. Barber, MD, PhD, FRCPC, Assistant Professor, G.S. Hazlewood, MD, PhD, FRCPC, Associate Professor, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, and Research Scientist, Arthritis Research Canada; cehbarbe@ucalgary.ca.
² D. Lacaille, MD, FRCPC, MHSc, Mary Pack Chair in Arthritis Research, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, and Scientific Director, Arthritis Research Canada.
³ M. Hall, MSc, CCRP, Research Associate, J.A. Rankin ACNP, PhD, Professor, K. Then, ACNP, CCN(C), PhD, Professor, Faculty of Nursing, University of Calgary, Calgary, Alberta.
⁴ V. Bohm, MSc, MPH, P. MacMullan, MBBCh, BAO, MRCPI, MD, Clinical Associate Professor, Rheumatology Division Head, D. Mosher MD, FRCPC, Professor, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta.
⁵ L.C. Li, PT, PhD, Professor, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, and Senior Research Scientist, Arthritis Research Canada.
⁶ C. Barnabe, MD, MSc, FRCPC, Associate Professor, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, and Senior Scientist, Arthritis Research Canada.
⁷ C.E. Barber, MD, PhD, FRCPC, Assistant Professor, G.S. Hazlewood, MD, PhD, FRCPC, Associate Professor, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, and Research Scientist, Arthritis Research Canada.
⁸ D.A. Marshall, PhD, Professor, Department of Community Health Sciences, Cumming School of Medicine, Canada Research Chair (Health Services and Systems Research), Arthur J.E. Child Chair in Rheumatology Research, Department of Medicine, University of Calgary, McCaig Institute for Bone and Joint Health, Calgary, Alberta, and Senior Research Scientist, Arthritis Research Canada.
⁹ K. Tsui, MScPT, ACPAC, K. English, Arthritis Patient Advisory Board (APAB).
¹⁰ J. Homik, MD, MSc, FRCPC, Professor, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. The authors declare no conflicts of interest.

PMID: 33191276
DOI: 10.3899/jrheum.201044

Abstract

Objective: To elucidate the essential elements of high-quality rheumatoid arthritis (RA) care in order to develop a vision statement and a set of strategic objectives for a national RA quality framework.

Methods: Focus groups and interviews were conducted by experienced qualitative researchers using a semistructured interview or focus group guide with healthcare professionals, patients, clinic managers, healthcare leaders, and policy makers to obtain their perspectives on elements essential to RA care. Purposive sampling provided representation of stakeholder types and regions. Recorded data was transcribed verbatim. Two teams of 2 coders independently analyzed the deidentified transcripts using thematic analysis. Strategic objectives and the vision statement were drafted based on the overarching themes from the qualitative analysis and finalized by a working group.

Results: A total of 54 stakeholders from 9 Canadian provinces participated in the project (3 focus groups and 19 interviews). Seven strategic objectives were derived from the qualitative analysis representing the following themes: (1) early access and timeliness of care; (2) evidence-informed, high-quality care for the ongoing management of RA and comorbidities; (3) availability of patient self-management tools and educational materials for shared decision making; (4) multidisciplinary care; (5) patient outcomes; (6) patient experience and satisfaction with care; and (7) equity, the last of which emerged as an overarching theme. The ultimate vision obtained was "ensuring patient-centered, high-quality care for people living with rheumatoid arthritis."

Conclusion: The 7 strategic objectives that were identified highlight priorities for RA quality of care to be used in developing the National RA Quality Measurement Framework.

Keywords: quality improvement; quality of health care; rheumatoid arthritis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Administrative Personnel
Arthritis, Rheumatoid* / therapy
Canada
Health Personnel
Humans
Qualitative Research
Quality of Health Care

Grants and funding

PJT 153265/CIHR/Canada