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Gaps in arthritis care detrimental to patients in the Maritimes: experts

Click to play video: 'Report highlights gaps in care for arthritis patients in Atlantic Canada'
Report highlights gaps in care for arthritis patients in Atlantic Canada
A report on the state of arthritis in Canada is highlighting gaps in care and research across the country for those dealing with the chronic disease. As Megan King reports, no province in Atlantic Canada was able to achieve above a D grade on the report card, underscoring the need for action. – Nov 14, 2023

Across the country, arthritis patients are falling victim to gaps in access to care — something experts in the Maritimes are calling a major barrier to research and damage prevention.

One in five Canadians suffer from arthritis, and in the Maritimes the need for timely, effective care is stronger than ever.

“A major barrier right now in the Maritimes is access to care…. We know that we’re not meeting the benchmarks right now for that particular indicator,” says Alex Legge, clinical rheumatologist and research scientist at Dalhousie University.

“We have very high wait times for both surgical intervention for arthritis, but also for rheumatologic evaluation for inflammatory arthritis.”

Legge says these wait times are due to a lack of resources with respect to the number of rheumatologists and rheumatology professionals in Atlantic Canada.

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According to the most recent Arthritis Society Canada report card on the state of arthritis in the country, care did not surpass a ‘C’ in any province or territory.

In the Atlantic provinces, the situation is more dire, with Nova Scotia, New Brunswick, and Newfoundland and Labrador scoring a ‘D,’ and Prince Edward Island an ‘F.’

When it comes to wait times for treatment in Nova Scotia, 50 per cent of people waiting for hip replacement surgery are served within 162 days, and for knee replacement surgery, 50 per cent are served within 194 days.

But, in more rural areas of the province, these wait times could be as high as 625 days for hip replacement.

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However, it isn’t only the rural parts of Nova Scotia where arthritis professionals are struggling to keep up with demand.

At QEII Health Sciences Centre in Halifax, 90 per cent of people on the wait-list receive care within 1,392 days.

According to Alissa Decker, Nova Scotia health director of neurosciences orthopedics and spine at QEII, this number is going down after the height of the pandemic.

“This year we’re doing better than last year and the year before. And so, we’re kind of close to those pre-pandemic volumes of surgeries that we’re doing,” she says. “We’re not quite exactly there, but we’re really close. And we’re doing all the things that we can to try to get as many surgeries done as possible.”

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Despite doing their best to provide treatment, Legge says the number of surgeries and clinical evaluations required limit rheumatologists’ ability to conduct valuable research.

She says due to the many risks of delaying care, including irreversible joint damage, patient treatment is always going to come first.

“I guess I just can’t emphasize enough how urgently we need to invest more resources into the clinical care of patients with arthritis in the Maritimes. And I think that, in turn, will facilitate our ability to do more arthritis research,” Legge says.

Sian Bevan, chief science officer at Arthritis Society Canada, says more funding in the arthritis sector is also needed. Bevan says over the last 14 years, arthritis research funding has either flatlined or declined, which poses challenges to bettering treatment methods.

Although arthritis is the most common chronic disease in the country, Bevan says people don’t often talk about it.

“You probably often hear someone say, ‘Oh, I need my hip replaced’ or ‘I need my knee replaced,’ You probably less often hear someone say, ‘Oh, I need my knee replaced because of my arthritis,’” she says. “When the reality is that the vast majority of all those surgeries — 99 per cent of knees, over 80 per cent of hip replacements — are caused by arthritis.”

Six million Canadians suffer from arthritis, and it is medically recommended that surgeries are completed within six months of patients being referred.

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This is due to the pain and discomfort associated with the disease that impedes patients’ everyday lives.

“Many people living with arthritis are living in pain,” Bevan says. “This is the leading cause of workplace disability. It’s really impacting people’s ability to have that full, wholesome life and it’s also impacting the quality of their life.”

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