Rapid Access Clinics: The Future of PsA Diagnosis?

From the onset of first symptoms, the time it takes to diagnose psoriatic arthritis is too long for many people; years or decades, sometimes. There is little doubt that more needs to be done to get timely diagnoses. The earlier you catch psoriatic arthritis, the better your prognosis and the less the likelihood you will do irreparable damage early on. It can sometimes feel like there is no progress being made for patients, so I wanted to share this positive development with you.

PsA Rapid Access Clinic – a first in Canada

I’m lucky to work in Canada’s most diverse city, Toronto. We have a vibrant culture, we’re forward-thinking, and we have some of the best hospitals in the country. Working here means that I’ve been able to access phototherapy treatments for my psoriasis, which would be impossible in most other cities. The hospital that offers the phototherapy program is the Women’s College Hospital (WCH), and I recently learned they have an incredible new initiative for diagnosing psoriatic arthritis; it’s called The Psoriatic Arthritis Clinic, and it’s Canada’s first Rapid Access Clinic for PsA.

What are Rapid Access Clinics? They’re clinics that can often accommodate self-referrals and get you access to a physician or nurse more quickly. Canada has Rapid Access Clinics for mental health, substance abuse, and even a breast cancer pilot program in B.C. (which cut the average diagnosis time in half).

How it works

I learned about the PsA initiative through the WCH phototherapy program, and a little about how it works. It’s still in the pilot stages, so a physician referral is currently required, but the ultimate goal will be for people with a formal diagnosis of psoriasis and self-reported joint pain/swelling/stiffness to book an appointment themselves. At the clinic they’ll take your medical history and use imaging techniques like ultrasound to assess joint damage. Based on your results, you would then be referred automatically to a rheumatologist. This project will significantly cut down on wait times and put the power in the hands of the patient. The physicians at The Psoriatic Arthritis Rapid Access Clinic also recognize that those of us with PsA often have other medical conditions, such as diabetes and heart disease, so their hope is that the clinic will also put these comorbidities on a physician’s radar and facilitate faster interventions.

If you’re in the Toronto area and have more questions, you can visit the WCH’s program here, and learn more about their team of dermatologists, rheumatologists, and physiotherapists.

What’s next?

The WCH team that runs The Psoriatic Arthritis Clinic is also working to investigate predisposing genetic factors, and looking at how genetic screening might help aid in diagnosis (or even catching PsA before it develops). They are also concerned with staying on top of how inflammation affects other organ systems, and how especially to help those with psoriatic arthritis manage conditions like vasculitis and heart disease.

Other hospitals and clinics are slowly gaining ground too. I see rheumatology clinics offering self-administered questionnaires to track flares between visits. There are similar Rapid Access Clinic initiatives for other inflammatory arthritis conditions in the UK (2, 3), Austria (4), and other Toronto hospitals like Mount Sinai (5). The more patients and physicians work together, the closer we get to earlier diagnoses and better patient care.

What about you? Are there any new initiatives in your area that you think will transform the future of PsA diagnosis?