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Clinical Medicine: Arthritis and Musculoskeletal Disorders

Synopsis: An open access, peer reviewed electronic journal that covers the treatment of arthritis, autoimmune disease and bone and cartilage conditions.


Indexing: 4 major databases. Pubmed indexing for NIH-funded research.

Processing time: Decision in 2 weeks for 90% of papers.

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About this journal

Aims and scope:

Clinical Medicine: Arthritis and Musculoskeletal Disorders is an international, open access, peer reviewed journal which considers manuscripts on the rationale and treatment of arthritis, and also autoimmune disease and diseases of the bone and cartilage. The journal welcomes articles on all aspects of the prevention, diagnosis and management of all associated disorders in addition to related genetic, pathophysiological and epidemiological topics.

The following topics are of specific, but not exhaustive, interest:

  • Pain management
  • Autoantibodies and autoimmunity
  • Biotechnology
  • Bone and cartilage biology
  • Gene therepy
  • Immunobiology
  • Inflammation
  • Molecular pathology and targeting
  • Therapeutics
  • Pharmacology
  • Gene signalling and regulation
  • Treatment outcomes and patient management
Editorial standards and procedures:

Submissions, excluding editorials, letters to the editor and dedications, will be peer reviewed by two reviewers.  Reviewers are required to provide fair, balanced and constructive reports.  

Under our Fairness in Peer Review Policy authors may appeal against reviewers' recommendations which are ill-founded, unobjective or unfair.  Appeals are considered by the Editor in Chief or Associate Editor.

Papers are not sent to peer reviewers following submission of a revised manuscript. Editorial decisions on re-submitted papers are based on the author's response to the initial peer review report.

Indexing:

This journal is indexed by the following services:

  • Google Scholar
  • CAS
  • DOAJ
  • EMBase

National Institutes of Health Public Access Policy compliant:

As of April 7 2008, the US NIH Public Access Policy requires that all peer reviewed articles resulting from research carried out with NIH funding be deposited in the Pubmed Central archive.

If you are an NIH employee or grantee Libertas Academica will ensure that you comply with the policy by depositing your paper at Pubmed Central on your behalf. 

ISSN: 1178-1149


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Barriers to Healthcare in a Multiethnic Cohort of Systemic Lupus Erythematosus (SLE) Patients: Patient and Physician Perceptions

Authors: Genevieve Law, Janet Pope, Sheliza Lalani, Earl Silverman, Glinda Cooper, Paul Fortin, Michel Zummer, C. Douglas Smith, Ross Petty, Lori Tucker, Lori Albert, Adam Huber, Susanne Ramsey, Hector Arbillaga, Gaëlle Chedéville, Marie Hudson and CaNIOS Investigators, Christine Peschken
Publication Date: 20 Apr 2009
Clinical Medicine: Arthritis and Musculoskeletal Disorders 2009:2 1-8

Genevieve Law1, Janet Pope1, Sheliza Lalani1, Earl Silverman2, Glinda Cooper3, Paul Fortin4, Michel Zummer5, C. Douglas Smith6, Ross Petty7, Lori Tucker7, Lori Albert8, Adam Huber9, Susanne Ramsey9, Hector Arbillaga10, Gaëlle Chedéville11, Marie Hudson11 and CaNIOS Investigators, Christine Peschken12

1The University of Western Ontario, St, Joseph’s Health Care, London, Ontario, Canada. 2University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada. 3NIEHS, Epidemiology Branch, Research Triangle Park, North Carolina, United States. 4University of Toronto; University Health Network—Toronto Western Hospital, Toronto, Ontario, Canada. 5Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada. 6Ottawa General Hospital, Ottawa, Ontario, Canada. 7University of British Columbia, Vancouver, British Columbia, Canada. 8University of Toronto, Toronto, Ontario, Canada. 9Dalhousie University, Halifax, Nova Scotia, Canada. 10University of Calgary, Calgary, Alberta, Canada. 11McGill University Health Centre, Montreal, Quebec, Canada. 12University of Manitoba, Winnipeg, Manitoba, Canada.

Abstract

Objective: Barriers to medical care may influence health status. It is unclear whether problems with access can predict clinical outcomes in lupus. This study aimed to determine whether care barriers are associated with increased disease activity and damage in a multi-center, multiethnic SLE cohort. We also compared concordance between care barriers as reported by the patient and lupus specialist.

Methods:  Data from SLE patients in 12 Canadian centers collected at annual visits, including demographics, treatment, disease activity and damage were analyzed.

Results:  654 patients were enrolled with ethnic groups being Caucasian [CC] (64%), Aboriginal [ABO] (9%), Asian [AS] (21%), and Black [BLK] (6%). 50.8% had at least one barrier to care including travel to a rheumatologist (32.0%), waiting to see a rheumatologist and cost of medications. Access to medication and costs were significantly associated with co-morbidity (p  0.001, p = 0.04). There were significant associations between ethnicity and any physician perceived care barrier (p   0.001), mostly in Aboriginal. Doctors identified half of patients who had access to medication problems (p = 0.003) and the relationship between doctors and patients identifying similar care barriers was weak (r = 0.09). A lower total house- hold income significantly predicted the presence of any care barrier (p   0.001).

Conclusions:  Despite access to a lupus specialist many care barriers were identified, although we found few associations between care barriers and patient outcomes. The cost of medication was related to SLE disease activity; however, we cannot determine if this was cause or effect. Care barriers identified by lupus patients are significantly underestimated by physicians.



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