Early help for people with rheumatoid arthritis

At the early rheumatoid arthritis clinic, a patient is assessed by nurse Karen White and started on a course of treatment by Dr. Majed Khraishi.

Rheumatoid arthritis is a serious disease affecting about 5,000 people in the province. Early detection and treatment is critical to avoiding long-term joint damage, but with a waiting list of about a year to see one of the province's few rheumatologists that's a hard goal to achieve.

However Dr. Majed Khraishi, Rheumatology, has found a way around the long waiting list by piloting Canada's first early rheumatoid arthritis clinic utilizing specialized nurses. “When we get referrals from family doctors we look at them and if we think a person has rheumatoid arthritis we get to them quickly and treat them.”

Dr. Khraishi started the program last October with the help of nurse Karen White, who has seven years experience in the area of arthritis. A small unrestricted grant from Merck Frosst has helped with some of the extra expenses, including hiring a summer student to finalize data.

Those patients suspected of having early rheumatoid arthritis are booked into the clinic at St. Clare's Hospital as soon as possible and screened by Ms. White. “The work is speeded up because she can see a patient while I'm seeing another,” explained Dr. Khraishi. “I go over her data and see how much her findings coincide with mine because we want to show scientifically that this works.”

Dr. Khraishi said that by proving this type of clinic works, specialized nurses like Ms. White can be trained and used in centres in the province and across the country. “These nurses can be our eyes and ears, they can help family doctors by screening and streamlining the patients and making sure they are seen quickly.”

Once a patient has started treatment, trained nurses can also monitor them for follow-up, freeing rheumatologists to see more urgent patients.

Dr. Khraishi said the pilot project is only dealing with rheumatoid arthritis right now because it is one of the more common and serious diseases. He foresees the time when early screening clinics using specialized nurses can be used for other areas of arthritis and other medical specialties.

Ms. White said she enjoys working in the clinic. “Dr. Khraishi is always testing me, but about 75 per cent of the time we're in agreement. Our aim is to speed up the process and cut down on the waiting period for early rheumatoid arthritis patients so they can be diagnosed and treated.”