Early detection urged | Centralized services disadvantage rural patients
New information has changed the way arthritis patients are diagnosed and treated, placing greater emphasis on early detection.
And while an interdisciplinary team — doctors, nurses, physiotherapists and dietitians — can work with patients to develop a personal management strategy, those suffering from the disease can’t benefit from that knowledge if they don’t get the necessary referrals.
“I think that the greatest need is going to be our ability to impress upon health-care professionals that there’s something to be learned about today’s arthritis, about the care and treatment of patients about the immediate referral, about the support systems that are required,” said Carol Hiscock, executive director of the Arthritis Society of Manitoba and Saskatchewan.
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A group, spanning the spectrum of health care, met in Saskatoon recently to learn about developments and issues in disease diagnosis, treatment and management. It takes a larger toll on the health-care system and economy as it grows, forcing more people onto disability.
“In the last decade, we really changed our minds about rheumatoid arthritis and extrapolated that to all arthritis,” Saskatoon rheumatologist Bindu Nair told the audience. “Why are we waiting for peoples’ joints to be damaged? If we intervene early, can we actually stop this process and hopefully change the way people feel and live their lives?”
Improved tests can allow for earlier detection of the disease, she said.
“We’re using drugs early and we’re finding that actually makes a difference in terms of preventing joint damage and disability …”
Nair is one of a handful of rheumatologists in the province located in Regina and Saskatoon. In Manitoba, the specialists are all in Winnipeg. That kind of centralization isn’t uncommon.
“There isn’t a province in this country that has enough rheumatologists,” said Hiscock, noting that access to services, as well as travel and money, is an issue for rural residents.
“The rheumatologists are in the two major centres. They don’t do rural clinics. That’s where early diagnosis and treatment comes is referral in to a rheumatologist,” said Hiscock.
Registered nurse Kandice Hennenfent said patients’ reports are key.
“We have to listen to the family, because those folks are the people that are the experts in what they need and what they require,” she said.
Follow-up care can be managed in a rural community, although resources will vary from location to location.
The Arthritis Society promotes a self-management program, including diet and pain management, for patients to complement other treatments.
“I think that the regionalized health-care system has the concept right and that is that people, health-care professionals, practise in team to support patient,” said Hiscock.
