Background/Purpose: Arthritis and musculoskeletal disorders are the most common chronic health conditions in Canada but there is a critical and growing shortage of rheumatologists relative to the needs of an aging population. Models of care involving advanced or extended role health disciplines practitioners to augment provision of arthritis care are emerging. Research supports these roles, however there are no studies to date documenting the workforce capacity or learning needs of advanced and extended role health disciplines.

Study Objectives

1. To capture descriptive information on the current workforce practices/attributes of advanced or extended role practitioners (ERPs) working in arthritis care in Canada.
2. To determine perceived opportunities and barriers in the pursuit of formal academic/clinical training to support these roles.

Methods: This Pan-Canadian exploratory cross-sectional self-report study was developed and based on the original Stand Up and Be Counted Rheumatologist Workforce Survey.

Data were collected using anonymous, online questionnaires deployed in early 2018 to groups of non-physician health disciplines professionals across Canada with potential to have undertaken formal and informal post-licensure training in arthritis care. Descriptive statistics were generated to describe the demographics and practice information of the sample. Qualitative responses were analyzed using Grounded Theory techniques.

Results: There were 141 respondents; 91 were identified as practising in an extended role capacity. Respondents were further characterized by profession (PT >OT >RN >Chiropractor/Pharmacist) and by their post-licensure training in arthritis care (ACPAC >CPSIA >ACR >Institutional-apprenticeship >ISAEC). Mean age of ERP respondents was 49±9 years, 87% (n=79) were female, and 41% (n=38) of ERPs planned to retire within 5-10 years. Geographic practice sites were Ontario > Alberta > British Columbia > Newfoundland and practice settings were urban academic (46.2%), community (38.5%) and rural (13.2%). Almost 50% (n=45) of ERPs treated patients with inflammatory arthritis. 54% (n=20) of non-ERP respondents had received some form of advanced training but were not deployed as ERPs; almost all 98% (n=89) of ERP respondents had undertaken advanced training. 95% (n=103) of all respondents agreed that formal training is necessary to work as an ERP but only half (n=52) felt that they had sufficient opportunities to pursue training. Barriers to pursuing training are various: from personal, geographic, and patient-care/patient-needs related, to administrative, post-program recognition and financial/remuneration concerns.

Conclusion:

No previous studies have assessed the workforce attributes of non-physician, advanced practice arthritis care providers or the perceived need for the training of ERPs working in arthritis/MSK care. It is important to measure the workforce capacity of these health disciplines practitioners as they evolve and integrate into the Canadian healthcare system.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/measuring-advanced-extended-practice-roles-in-arthritis-and-musculoskeletal-care-in-canada-stand-up-and-be-counted-too-2/