St. Lawrence Health System
Rheumatoid arthritis (RA) is a complex autoimmune disease where the immune system attacks healthy joint tissue; causing pain, swelling, and stiffness of the joints. This disease effects lots of people in the US and can lead to major joint damage if not properly treated. In rural areas like northern NY, these are underserved areas for RA patients, thus many patients struggle to get the appropriate care. This model is testing whether primary care providers (PCP) can safely and effectively provide stable RA patients with the proper treatment rather than send them to a specialist. PCPs were trained through classes, case reviews, and a final exam. Patients will be randomly assigned to either see a trained PCP or their normal rheumatologist at the rheumatology clinic. This study will examine how patients are doing over a year using medical exams and patient feedback. If this model proves to be successful, it will make RA treatment easier and more affordable for patients.
Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint inflammation, stiffness, and pain. If left untreated, RA can lead to irreversible joint damage and functional impairment. This disease has significant impact on the healthcare system of the United States because it requires specialized care, while also affection about 1.5 million individuals \[Pfizer, 2025\]. Within the United States, access to specialized care is not widespread, with large disparities between urban and rural areas. Rural areas have about 1/8th the specialists per 100,000 people when compared to…
Inclusion Criteria: * Fulfillment of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis Using these criteria, a classification as "definite RA" is based upon the presence of synovitis in at least one joint, the absence of an alternative diagnosis that better explains the synovitis, and the achievement of a total score of at least 6 (of a possible 10) from the individual scores in four domains. The highest score achieved in a given domain is used for this calculation. These domains and their values are: * Number and site of involved joints: * 2 to 10 large joints (from am…
RA patients will be randomized to receive their RA care via their established PCP who completed a structured training course in RA and who has monthly case review/consultation sessions with the rheumatology team in this study
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