E A L T H P R O M O T I O N
Society calls for chronic disease management strategy
Jonathan Carpenter Photo
Dr. Sean Hamilton
The Arthritis Society,
Newfoundland and Labrador Division, is calling on the Department of
Health and Community Services to establish a Chronic Disease Prevention
and Management Strategy for people in the province with arthritis.
By Jonathan Carpenter
The Arthritis Society, Newfoundland
and Labrador Division, is calling on the Department of Health and
Community Services to establish a Chronic Disease Prevention and
Management Strategy for people in the province with arthritis.
In February, the Arthritis Society
circulated a petition calling on residents of the province to join the
call to action by signing their names in support of recommendations for
improving arthritis care.
“Timely care and effective treatment for
patients with arthritis is essential for minimizing and preventing
disability,” says Executive Director Brenda Kitchen. “Patients are
already waiting too long to see specialists and, as our population ages,
the prevalence of arthritis will place a major burden on the province’s
health care system.”
The petition calls for timely access to an
adequate number of rheumatology specialists with wait lists that meet
appropriate standards of care. Additionally, it calls for a minimum of
four designated in-patient rheumatology beds at St. Clare’s Mercy
Hospital and access to a rheumatology day program for out-patient care
and rehabilitation. It also calls for a review of the Newfoundland and
Labrador Prescription Drug Program to further reduce financial barriers
to biologic drug therapies.
The Arthritis Society says a major
component of the strategy must also focus on added training and support
for primary care physicians in the early diagnosis and treatment of
Currently, patients wait on average 9.6
months to see a rheumatologist for inflammatory arthritis and 42 months
for chronic non-inflammatory rheumatic conditions. According to
rheumatologist Dr. Sean Hamilton, people with inflammatory arthritis
should see a specialist within six weeks of diagnosis.
“Any delay in treatment for patients with
arthritis can have potentially irreversible consequences. Permanent
damage starts at four months. My wait list is more than 10 months. For
non-urgent cases, the wait is four years,” says Dr. Hamilton.
Dr. Hamilton says it’s frustrating for
physicians and staff who have the skills to deliver quality care to
their patients, but don’t have the resources to deliver it in a timely
or effective manner.
“Ten years ago, we had 12 dedicated
hospital beds to treat our most severe patients. They had access to a
multidisciplinary rheumatic team that included nurses, a
physiotherapist, occupational therapist, social worker, internal
medicine resident, and a rheumatologist. Unfortunately, those options no
longer exist and it’s a fight just to get people admitted. Most times,
patients are admitted through the emergency department, which is not the
appropriate place to admit them,” says Dr. Hamilton.
“In addition to the four protected
in-patient beds for the severely ill rheumatic patients, we need a
Rheumatic Health Day Program (RHDP) for ambulatory rheumatic patients.
We have already organized a RHDP program, which has been approved in
principle by Eastern Health, but the health authority will not provide
any funding to get the program started,” he adds.
The Arthritis Society says the current
situation is not consistent with quality patient care standards, nor is
there a practice environment that supports the recruitment and retention
“Prevention, early diagnosis and treatment
are critical to preventing and minimizing disability. Without additional
rheumatologists, these wait times are unlikely to improve,” says
Kitchen. “That’s why it’s so important that our province be committed to
making progress on a chronic disease management strategy. Unless access
and wait times are improved, we will continue to experience an endless
cycle of high social, economic and medical costs due to disability.”