spring 2009

H E A L T H   P R O M O T I O N
Arthritis 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 arthritis.

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 of rheumatologists.

“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.”



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