Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
An Overview of Clinical Performance by Advanced Clinician Practitioner in Arthritis Care Program-Trained Therapists: A Two-Year Prospective Study.
Passalent1, Laura A., Kennedy2, Carol, Soever3, Leslie J., Warmington2, Kelly, Lineker4, Sydney C., Lundon2, Katie, Shupak5, Rachel
University Health Network, Toronto, ON
St. Michael's Hospital, Toronto, ON
Mount Sinai Hospital, Toronto, ON
The Arthritis Society, Toronto, ON
St. Michaels Hospital, Toronto, ON
Hospital for Sick Children, University of Toronto, Toronto, ON
The Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program is an innovative clinical and academic training program focused on assessment, diagnosis, triage and independent management of selected musculoskeletal and arthritis disorders. The aim of the program is to prepare experienced physical and occupational therapists for extended practice roles and to develop innovative models of arthritis care across diverse clinical settings. It is now critical and timely to evaluate the ACPAC program graduates' clinical performance. The specific objectives of this study were to examine the clinical performance of ACPAC program-trained therapists with respect to the following indicators: 1) referral source; 2) patient volumes and 3) patient diagnoses.
A longitudinal survey was administered to 30 ACPAC graduates working at 15 healthcare institutions across the Canadian province of Ontario. These included urban, rural, academic, non-academic, adult and paediatric settings. An electronic questionnaire was sent each quarter for the 2009 and 2010 fiscal years. Questions relating to clinical performance were established through peer consensus and were tested for face validity. Descriptive statistics were used to summarize the data.
The mean response rate per quarter was 91.3% (range = 83.3% 96.7%). ACPAC graduates saw a total of 13407 patients during the 2009 fiscal year and 14546 patients during the 2010 fiscal year. In 2009, the majority of patients were referred by a family physician (43.9%), followed by 35.8% of patients referred by a specialist. In contrast, 51.5% of patients were referred by a specialist in the 2010 fiscal year, followed by 37.3% referred by a family physician. Over the two-year period, new consults constituted 24.9% of all patients seen, of which 7.3% were paediatric. Just over half (55.6%) of patients seen by ACPAC program-trained therapist were for follow-up, with 17.5% of follow-ups specific to the paediatric population. The remaining patients underwent triage by ACPAC program-trained therapists. Approximately half (51.6%) of the patients seen had a diagnosis of osteoarthritis (OA), followed by rheumatoid arthritis (RA) (14.7%), juvenile idiopathic arthritis (11.1%) and the remainder having diagnoses related to various inflammatory and non-inflammatory arthropathies.
ACPAC program-trained therapists working in the province of Ontario are primarily seeing patients with OA or RA in a follow-up capacity, with most patients being referred by either a family physician or specialist. The above evaluation provides a snapshot of the clinical performance of the ACPAC program-trained therapist in terms of volumes, referral sources and diagnoses and identifies an evolving role in the triage of patients, which may improve access to care. The increase in referrals from specialists may reflect their growing awareness of the potential triage role offered by extended role practitioners. Knowing the clinical performance of this unique human health resource can help to shape strategic planning for health care clinical utilization and delivery of care.
To cite this abstract, please use the following information:
Passalent, Laura A., Kennedy, Carol, Soever, Leslie J., Warmington, Kelly, Lineker, Sydney C., Lundon, Katie, et al; An Overview of Clinical Performance by Advanced Clinician Practitioner in Arthritis Care Program-Trained Therapists: A Two-Year Prospective Study. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1732