The ‘Calgary Early RA Care Pathway’ emphasizes a patient-centered and interdisciplinary approach to early RA identification and treatment. Pathway implementation has been facilitated by nursing protocols and evaluation includes continuous monitoring of key indicators. Care pathway elements include triage processes, critical diagnostics, pre-treatment screening and vaccinations, and uptake of suggested RA pharmacologic treatment using shared decision-making strategies. Our care pathway promotes an approach to patient-centered early RA care using an interdisciplinary approach. Implementation of the care pathway and development of strategies for evaluation is ongoing across multiple practice sites (Phase 4).
The care pathway was revised for content and implementation considerations based on feedback received. In Phase 3, an education day was held with approximately 40 physicians (rheumatologists and rheumatology residents), members of our interprofessional team, and two clinic managers to review the proposed care elements through presentations and small group discussions. care pathway informed by evidence-based practice in Phase 2. This provided data to a small interprofessional working group of rheumatology team members who drafted an initial. In Phase 1, an anonymous survey was electronically distributed to division rheumatologists. To develop an interdisciplinary care pathway for early rheumatoid arthritis (RA) including referral triage, diagnosis, and management. Patient numbers were also relatively high in groups other than childhood, indicating that age-related distribution in primary care may be shifting to older ages. Patients with AD are prevalent in all age groups in Finnish primary care. There were no differences between direct age group comparisons (p = 0.303), sex (p = 0.389), or number of consultations/patient (p = 0.235). Regression analysis indicated a statistically significant association of age group with patient numbers (p = 0.032) and number of consultations (p = 0.030). A substantial proportion of patients with AD were aged > 50 years (3,515 patients, 16.81%) or >65 years (1,947 patients, 9.31%).
The highest numbers of patients with AD were in the age groups 0–14 years (9,922 patients, 47.46%) and 15–65 years (9,144 patients, 43.74%). The database comprised the main diagnoses of all visits to public primary healthcare. The aim of this study was to analyse the nationwide database of the Finnish Institute for Health and Welfare regarding the number of patients with AD and of general practitioner consultations in Finland during 2018. The burden of atopic dermatitis (AD) appears to be increasing in adult and elderly patients.