ArticleJournal of multidisciplinary healthcare2019
An advanced clinician practitioner in arthritis care can improve access to rheumatology care in community-based practice.
Article in Journal of multidisciplinary healthcare, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed, 26 citations in OpenAlex.
- Determining the Impact of a Physiotherapist-Led Primary Care Model for Hip and Knee Pain: Protocol and Analysis Plan for a Cluster Randomized Controlled Trial With Process Evaluation.JMIR research protocols · 2026Article
- Self-Assessment Triage for Inflammatory Arthritis: A Pilot Randomized Controlled Trial.ACR open rheumatology · 2026Article
- A retrospective study of pediatric rheumatology referrals reveals large discrepancies in referring providers' musculoskeletal exams.Pediatric rheumatology online journal · 2026Article
- What is the global perspective on advanced practice physiotherapy: A qualitative study across five countries.PloS one · 2025Article
- First contact physiotherapists: are they able to reduce the burden on rheumatology services? A critical review of the evidence base.Rheumatology advances in practice · 2024Review
- Improving access to care for rheumatology services in Canada.Clinical rheumatology · 2023Review
- Task shifting in the care for patients with hand osteoarthritis. Protocol for a randomized controlled non-inferiority trial.BMC musculoskeletal disorders · 2021Article
- An Advanced Clinician Practitioner in Arthritis Care (ACPAC) Maintains a Positive Patient Experience While Increasing Capacity in Rheumatology Community Care.Journal of multidisciplinary healthcare · 2021Article
- Implementing models of care for musculoskeletal conditions in health systems to support value-based care.Best practice & research. Clinical rheumatology · 2020Review
- Measuring Advanced/Extended Practice Roles in Arthritis and Musculoskeletal Care in Canada.ACR open rheumatology · 2020Article
- Patient, Rheumatologist and Therapist Perspectives on the Implementation of an Allied Health Rheumatology Triage (AHRT) Initiative in Ontario Rheumatology Clinics.Pragmatic and observational research · 2020Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo facilitate access and improve wait times to a rheumatologist's consultation, this study aimed to 1) determine the ability of an advanced clinician practitioner in arthritis care (ACPAC)-trained extended role practitioner (ERP) to triage patients with suspected inflammatory arthritis (IA) for priority assessment by a rheumatologist and 2) determine the impact of an ERP on access-to-care as measured by time-to-rheumatologist-assessment and time-to-treatment-decision. MATERIALS AND
methodsA community-based ACPAC-trained ERP triaged new referrals for suspected IA. Patients with suspected IA were booked to see the rheumatologist on a priority basis. Diagnostic accuracy of the ERP to correctly identify priority patients; the level of agreement between ERP and rheumatologist (Kappa coefficient and percent agreement); and the time-to-treatment-decision for confirmed cases of IA were investigated. Retrospective chart review then compared time-to-rheumatologist-assessment and time-to-treatment-decision in the solo-rheumatologist versus the ERP-triage model.
resultsOne hundred twenty-one patients were triaged. The ERP designated 54 patients for priority assessment. The rheumatologist confirmed IA in 49/54 (90.7% positive predictive value [PPV]). Of the 121 patients, 67 patients were designated as nonpriority by the ERP, and none were determined to have IA by the rheumatologist (100% negative predictive value [NPV]). Excellent agreement was found between the ERP and the rheumatologist (Kappa coefficient 0.92, 95% CI: 0.84-0.99). In the ERP-triage model, time-from-referral-to-treatment-decision for patients with IA was 73.7 days (SD 40.4, range 12-183) compared with 124.6 days (SD 61.7, range 26-359) in the solo-rheumatologist model (40% reduction in time-to-treatment-decision).
conclusionA well-trained and experienced ERP can shorten the time-to-Rheumatologist-assessment and time-to-treatment-decision for patients with suspected IA.
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