An interventional study of Honoraria and Outreach in Rheumatic Diseases, Inflammatory Arthritis and Rheumatoid Arthritis (RA), sponsored by University of British Columbia. Not yet recruiting at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-07-04.
Sponsored by University of British Columbia · Not applicable, Interventional, and Health services research
The primary goal of this study is to determine whether providing patient honoraria and/or outreach services can improve the attendance rate of appointments at an inner city rheumatology clinic in Vancouver, British Columbia.
The main question it aims to answer are:
The researchers will compare providing patient honoraria to providing both honoraria and outreach services, and compare each of these to the regular appointment schedule without honoraria or outreach.
Participants will:
Our study aims to enhance the existing twice-monthly rheumatology clinic at the Pender Community Health Centre with a rheumatology-specific outreach service for patients with inflammatory arthritis. This service will be provided by a rheumatology subspecialty trainee under the supervision of two attending rheumatologists. This will consist of biweekly phone calls, text messages, or home visits as per the patient's preference, at times flexible to patient needs. This will be in addition to monthly in-person assessment and bloodwork monitoring with adjustment as clinically indicated by their treating rheumatologist. Outreach services will include management of medications and side effects, proactive screening for infections, coordination of rheumatologic and general healthcare with their Primary Care Provider, social service navigation, and reminders for appointments and lab monitoring. All participants will be provided with a $20 honorarium for each in-person assessment they attend as part of the study.
The investigators will aim to enroll 20 participants between July 2025 and October 2025. Participants will be randomized to either honorarium with outreach or honorarium alone arms in a 1:1 fashion, stratified by housing status (unhoused and emergency sheltered in one strata, provisionally accommodated and stably housed in the second strata).
All enrolled participants will receive a $20 honorarium for each in-person assessment with completed monitoring bloodwork as requested by the treating rheumatologist. The program will last 6 months for each patient from time of enrolment, or until a patient chooses to leave the program, whichever is sooner. At baseline, participants will complete two surveys: one on their general health status, and one specific to their rheumatic disease. At the 3-month and 6-month visits, these surveys will be repeated, and a semi-structured interview will be completed to obtain feedback on the pilot program.
The outcomes of this study will inform how rheumatologists can better care for those who live with inflammatory arthritis and are also marginalized by extreme poverty and/or housing instability. The investigators plan on disseminating and discussing results with our participants, community members, inner city physicians, and rheumatologists. If there are specific positive themes or outcomes from the study, the investigators will advocate for additional resources to permit long-term implementation and further study to confirm results, make further improvements to our program, and improve generalizability.
377 studies on the registry are indexed under Rheumatic Diseases; 79 are open to participants now.
This study's planned enrollment of 20 is below the median of 74 across 210 interventional studies indexed under Rheumatic Diseases.
Browse Rheumatic Diseases studies →University of British Columbia is the lead sponsor of 1,309 studies on the registry; 253 are open to participants now.
Of its 6 completed or terminated interventional studies of FDA-regulated products, 1 (17%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Participants in this arm of the study will only receive honoraria and not outreach
Behavioral: Honoraria
Participants in this arm of the study will receive both honoraria and outreach services
Behavioral: Honoraria · Behavioral: Outreach
The attendance rate to follow-up appointments among all patients with inflammatory arthritis due to a rheumatic disease at the Pender Rheumatology Clinic from Jan 2023 to Jun 2025.
A $20 honorarium for each appointment attended with completed bloodwork if requested.
A personalized outreach service specific for rheumatic disease.
Attendance at in-person follow-up appointments
Adherence to in-person follow-up measured by the ratio of appointments attended to appointments scheduled.
Time frame: Cumulative over 6 months
Clinical Disease Activity Index (CDAI)
The change in Clinical Disease Activity Index from baseline to 3-months and 6-months. The Clinical Disease Activity Index is a validated disease outcome measure in Inflammatory Arthritis ranging from 0 to 76. A higher score means a worse outcome.
Time frame: 3-month and 6-month intervals.
Patient Qualitative Feedback
Patient qualitative feedback on the program via semi-structured interview.
Time frame: 3-month and 6-month intervals.
Patient Reported Understanding of Disease and Medications
Patient Reported Understanding of Disease and Medications, as measured by likert scale at baseline, 3 months, and 6 months. The likert scale will range from 1 to 10, with higher scores indicating better understanding.
Time frame: 3-month and 6-month intervals.
Patient reported pain related to arthritis
Patient reported pain related to arthritis on a visual analogue scale. The visual analogue scale is a validated measure of pain in arthritis, where participants are asked to indicate their severity of pain within the previous week on a 0 to 100mm score. A score of 0 indicates "no pain", and a score of 100 indicates "worst possible pain".
Time frame: 3-month and 6-month intervals
Tender Joint Count
Change in the number of tender joints as measured by their treating clinician on a 28-joint count basis.
Time frame: At the 6-month interval.
Swollen joint count
Change in the number of swollen joints as measured by their treating clinician on a 28-joint count basis.
Time frame: At the 6-month interval.
Number of Emergency Department Visits During the Study Period
Number of Emergency Department Visits During the Study Period
Time frame: Cumulative over 6 months
Number of Days in Hospital During the Study Period
Number of Days in Hospital During the Study Period
Time frame: Cumulative over 6 months
Serious Infections
Number of Serious Infections Requiring Urgent Care or Emergency Department Visitation
Time frame: Cumulative over 6 months
Documents are hosted by the registry — open the source record to download them.
Plan to share: No — We are working with a uniquely vulnerable population who are marginalized by extreme poverty, and feel that the risks of identification by sharing individual patient data outweigh the academic benefits in this study.
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University of British Columbia