The Early Arthritis Program
Martin Family and Research Centre

Criteria for inclusion into Cohort

At Least one of the following symptoms:

At Least one of the following:

Patient Procedures

Patients will be seen within 2-4 weeks of receiving the referral
Referrals will be forwarded by clinic secretary to nurse practitioner upon receipt
Patient will then be contacted and screened by nurse practitioner (using screening questionnaire)
Patients will be seen by the physician and nurse practitioner at baseline and every 3 months for the first year, then every 6 months thereafter, where the following will be completed:
- Physical and patient questionnaires
- HAQ and SF36
- Long labs annually and short labs in between
- X-rays of hand and feet annually

At baseline visit, CXR and TB skin test will be organized
Bone mineral density will be done according to Canadian guidelines
If patients do not have another rheumatologist, a check-up visit will be schedules 4-6 weeks after baseline visit to discuss medication response and possible side affects. No special forms or blood work at this time.
In between scheduled protocol visits, patients will be seen as necessary. During these visits no special forms or blood work will be done.
The assessment protocol outline timing of protocols, labs, and x-rays
Patient blood work will be flagged for screening by the lab at our hospital

Clinic Procedures

Chart Preparation

The clinic secretary will prepare charts prior to visit. Questionnaires that need to be completes at the visit will be clipped to the front of the chart.
On the appointment list, clinic secretary will identify which labs, x-rays or special forms are required for visit.
Pre-labeled lab requisitions will be attached to front of chart, along with x-ray requisition

Clinic Day

The patients will be asked to arrive 15-30 minutes prior to appointment to register and out the fill appropriate forms
The volunteer/receptionist will stamp the appropriate forms
Patient will be given patient questionnaire, HAQ, SF36 and any other forms to fill out while in the waiting room
If the patient's baseline visit:
- They will be seen by a fellow and/or staff physician (1 hour) first who will:
- Complete physician protocol
- Decide id patient meets inclusion criteria
- If they meet criteria, labs and x-ray requisitions, TB skin test forms will be given
- They will then be seen by nurse practitioner (30 min) who will:
- Ensure all forms are completed correctly
- Discuss goals of TEAP and obtain consent
- Obtain consent for extra blood for genetic testing and blood banking
- Discuss medications and side effects
- Give patient educational materials on RA

Referrals for consults require completion of "Request for Consultation" forms
Procedure Order Forms and Requests for Consultation forms are given to clinic secretary
At the end of clinic, the nurse practitioner will review charts and ensure that all forms are complete correctly and completely and appropriate requisitions have been given.