Background/Purpose:  Emerging models of care in rheumatology are integrating interdisciplinary approaches at different stages of the patient’s care pathway. Such models of have recently been implemented in the early identification of axial spondyloarthritis (SpA). The Toronto Western Hospital SpA Screening Clinic links with community-based primary care physicians (PCPs), physiotherapists (PTs), chiropractors (DCs) and nurse practitioners (NPs) to facilitate the early detection of axial SpA and uses advanced practice physiotherapists and specialist rheumatologists located at an academic tertiary care hospital to confirm diagnosis and initiate early treatment for axial SpA. Collaborative inter-professional practice is an essential component for successful implementation of novel models of care for chronic diseases that require ongoing assessment and management from many health care professionals. The objective of this study was to examine the inter-professional satisfaction and perceptions of collaborative practice of an innovative model of care for the early detection of axial SpA in Toronto, Canada.

Methods:  A cross-sectional survey was conducted of referring health care providers (HCPs) to the Toronto Western Hospital SpA Screening Clinic and included PCPs, PTs, DCs and NPs. HCPs were sent an electronic questionnaire with questions related to general satisfaction of the SpA Screening Clinic and HCP’s perceptions and experience with the inter-professional collaborative process of the SpA Screening Clinic. An adapted version of the Modified Index of Interdisciplinary Collaboration was used to assess inter-professional collaboration. The survey was administered using Survey Monkey®. Data analyses consisted of descriptive statistics and were conducted using Microsoft Excel 2010.

Results:  Thirty-two out of 59 (54%) referring HCPs participated in the survey. The majority of respondents were PCPs (65.6%), followed by PTs or DCs (21.9%). The majority of referring HCPs to the SpA Screening Clinic reported positive indicators of satisfaction and included: receiving communication about their referred patients in a timely manner (53.1%); being informed regarding their referred patients’ management plan (51.6%) and future re-referral rate for another patient with suspected axial SpA (83.9%). Overall perceptions of inter-collaborative practice were high with respect to referring HCPs relationship with the SpA Screening Clinic: interdependence subscale mean score=2.04 (SD 0.41); newly created professional activities subscale mean score=2.19 (SD 0.2); flexibility subscale mean score=2.47 (SD 0.18) and collective ownership subscale mean score=2.25 (SD 0.21), with 1 representing the highest possible perception of collaboration and 5 being the lowest possible perception.

Conclusion:  These results suggest overall inter-professional satisfaction and high levels of perceived inter-professional collaboration with an innovative model of care aimed at the early detection of axial SpA. The results of this study may inform future research on the impact of inter-professional collaboration on outcomes for patients attending the Toronto Western Hospital SpA Screening Clinic.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/inter-professional-satisfaction-and-perceptions-of-collaborative-practice-of-an-innovative-model-of-care-for-the-early-detection-of-axial-spondyloarthritis/