Most of us have at least once waited a few hours to receive care for a throat infection or other health problem. What about complex health problems that extend over time and require different types of treatment from a large number of health specialists?
Goal
Rheumatic diseases such as rheumatoid arthritis, osteoarthritis and fibromyalgia affect 1 in 5 people in North America and Europe. What do all these diseases have in common? Pain. Pain is an important aspect of the disability associated with these diseases. In multidisciplinary pain clinics, healthcare specialists strive to improve the quality of life of people living with these chronic diseases, while combining pharmacological (medication) and non-pharmacological (exercise, cognitive-behavioural therapy, self-management) interventions. Unfortunately, waiting times for access to these clinics can be months or even years. In this study, scientists wanted to understand how waiting time for these clinics affects treatment outcomes. In other words, does waiting time have an impact on the extent to which people improve with treatment?
Methodology
So, the scientists used data collected between 2008 and 2014 as part of the Quebec Pain Registry. This database includes data from people living with chronic non-cancer pain who were receiving healthcare services in multidisciplinary pain clinics. Data from this registry were filtered, and people with rheumatic diseases were divided into three groups according to the expected time to receive services in a pain clinic: less than 2 months, 2 to 6 months and more than 6 months. The research team wanted to know whether clinical outcomes (pain interference with daily life, pain intensity and quality of life) differed between these groups.
Main findings
The research team analyzed data from 3,230 patients living with osteoarthritis, fibromyalgia, rheumatoid arthritis or other rheumatic diseases. In general, those who waited longer to receive care showed less improvement with treatment than those who received treatment after waiting two months. These differences in the level of improvement were not clinically significant, but there were nevertheless more people showing improvements in the group who waited less than 2 months to receive care than in the other groups. These results were more significant for people with fibromyalgia or osteoarthritis.
Take home message
According to the results obtained in this study, longer waiting times may lead to less clinical improvement. Further efforts therefore seem necessary to develop strategies to reduce waiting times for healthcare (e.g., self-management interventions, prioritization strategies), in order to better meet the needs of people living with pain, including those with rheumatic diseases.
