TY - JOUR T1 - Extended Role Practitioners to Improve Access to Rheumatic Care: What is the Evidence in the Classification of Patients with Spondyloarthritis? JF - The Journal of Rheumatology JO - J Rheumatol SP - 483 LP - 485 DO - 10.3899/jrheum.190693 VL - 47 IS - 4 AU - VÉRONIQUE LOWRY AU - FRANÇOIS DESMEULES Y1 - 2020/04/01 UR - http://www.jrheum.org/content/47/4/483.abstract N2 - Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that predominantly affects the axial skeleton1. AxSpA is a type of SpA that includes nonradiographic as well as radiographic SpA, also referred to as ankylosing spondylitis1. These 2 diagnoses may often be considered 2 stages of the same pathology2. Patients with axSpA usually present with chronic low back and pelvis pain with morning stiffness. However, these symptoms are also present in patients with low back pain of other etiologies. Therefore, the diagnosis of SpA is a challenge for clinicians especially in the earlier stage of the disease3,4. Early diagnosis and management of SpA is important because this pathology can cause major disability to the patients, who are often affected in the third decade of their lives4,5. Moreover, patients with a delayed diagnosis have worse outcomes regarding bony pathologic changes, function or spinal mobility, because of the delay in initiating treatment with tumor necrosis factor blockers5,6.However, timely access to rheumatic care is limited in several countries as we observe a growth of the prevalence of arthritis and a decrease in the number of rheumatologists7. With the growing need for rheumatic and orthopedic care, models of care are emerging that include extended role practitioners (ERP) such as physiotherapists, occupational therapists, and nurses. In these models, the ERP are trained as skilled professionals to provide musculoskeletal or rheumatic care and act as the first-contact provider. The ERP may perform medical acts such as making a diagnosis, triaging surgical candidates, or prescribing medication or infiltrations8,9. In response to the problem of access to rheumatologic care, clinicians’ organizations and others have advocated for new models of care with ERP, including physiotherapists10 … Address correspondence to V. Lowry, 5415 Boulevard de l’Assomption, Montréal, Quebec H1T 2M4, Canada. E-mail: veronique.lowry{at}umontreal.ca ER -