PT  - JOURNAL ARTICLE
AU  - Claire E.H.  Barber
AU  - Deborah A.  Marshall
AU  - Dianne P.  Mosher
AU  - Pooneh Akhavan
AU  - Lori Tucker
AU  - Kristin Houghton
AU  - Michelle Batthish
AU  - Deborah M.  Levy
AU  - Heinrike Schmeling
AU  - Janet Ellsworth
AU  - Heidi Tibollo
AU  - Sean Grant
AU  - Dmitry Khodyakov
AU  - Diane Lacaille
AU  - and the Arthritis Alliance of Canada Performance Measurement Development Panel
TI  - Development of System-level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada
AID  - 10.3899/jrheum.150839
DP  - 2016 Jan 15
TA  - The Journal of Rheumatology
PG  - jrheum.150839
4099  - http://www.jrheum.org/content/early/2016/01/02/jrheum.150839.short
4100  - http://www.jrheum.org/content/early/2016/01/02/jrheum.150839.full
AB  - Objective To develop system-level performance measures for evaluating the care of patients with inflammatory arthritis (IA), including rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis. Methods This study involved several methodological phases. Over multiple rounds, various participants were asked to help define a set of candidate measurement themes. A systematic search was conducted of existing guidelines and measures. A set of 6 performance measures was defined and presented to 50 people, including patients with IA, rheumatologists, allied health professionals, and researchers using a 3-round, online, modified Delphi process. Participants rated the validity, feasibility, relevance, and likelihood of use of the measures. Measures with median ratings ≥ 7 for validity and relevance were included in the final set. Results Six performance measures were developed evaluating the following aspects of care, with each measure being applied separately for each type of IA except where specified: waiting times for rheumatology consultation for patients with new onset IA, percentage of patients with IA seen by a rheumatologist, percentage of patients with IA seen in yearly followup by a rheumatologist, percentage of patients with RA treated with a disease-modifying antirheumatic drug (DMARD), time to DMARD therapy in RA, and number of rheumatologists per capita. Conclusion The first set of system-level performance measures for IA care in Canada has been developed with broad input. The measures focus on timely access to care and initiation of appropriate treatment for patients with IA, and are likely to be of interest to other arthritis care systems internationally.