Skip to main content

Temporal trends in prevalence, incidence, and mortality for rheumatoid arthritis in Quebec, Canada: a population-based study

Clinical Rheumatology volume 36, pages 2667–2671 (2017)Cite this article

Abstract

Health administrative data are a potentially efficient resource to conduct population-based research and surveillance, including trends in incidence and mortality over time. Our objective was to explore time trends in incidence and mortality for rheumatoid arthritis (RA), as well as estimating period prevalence. Our RA case definition was based on one or more hospitalizations with a RA diagnosis code, or three or more RA physician-billing codes, over 2 years, with at least one RA billing code by a rheumatologist, orthopedic surgeon, or internist. To identify incident cases, a “run-in” period of 5 years (1996–2000) was used to exclude prevalent cases. Crude age and sex-specific incidence rates were calculated (using data from 2001 to 2015), and sex-specific incidence rates were also standardized to the 2001 age structure of the Quebec population. We linked the RA cohort (both prevalent and incident patients) to the vital statistics registry, and standardized mortality rate ratios were generated. Negative binomial regression was used to test for linear change in standardized incidence rates and mortality ratios. The linear trends in standardized incidence rates did not show significant change over the study period. Mortality in RA was significantly higher than the general population and this remained true throughout the study period. Our prevalence estimate suggested 0.8% of the Quebec population may be affected by RA. RA incidence appeared relatively stable, and mortality was substantially higher in RA versus the general population and remained so over the study period. This suggests the need to optimize long-term RA outcomes.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. World Health Organization (2006) Preventing chronic diseases: a vital investment. WHO Press. http://www.who.int/chp/chronic_disease_report/contents/en/. Accessed 12 Aug 2015

  2. Nations Unies (2011) Déclaration politique de la Réunion de haut niveau de l’Assemblée générale sur la prévention et la maîtrise des maladies non transmissibles. Assemblée générale des Nations Unies. http://www.un.org/fr/documents/view_doc.asp?symbol=A/66/L.1. Accessed 12 Aug 2015

  3. Health Canada (2003) Chronic disease surveillance in Canada: a background paper. Health Canada. http://publications.gc.ca/collections/Collection/H39-666-2003E.pdf. Accessed 12 Aug 2015

  4. Bernatsky S, Lix L, O'Donnell S, Lacaille D, Network CANRAD (2013) Consensus statements for the use of administrative health data in rheumatic disease research and surveillance. J Rheumatol 40(1):66–73. https://doi.org/10.3899/jrheum.120835

    Article  PubMed  Google Scholar 

  5. Bernatsky S, Lix L, Hanly JG, Hudson M, Badley E, Peschken C, Pineau CA, Clarke AE, Fortin PR, Smith M, Bélisle P, Lagace C, Bergeron L, Joseph L (2011) Surveillance of systemic autoimmune rheumatic diseases using administrative data. Rheumatol Int 31(4):549–554. https://doi.org/10.1007/s00296-010-1591-2

    CAS  Article  PubMed  Google Scholar 

  6. Blais C, Jean S, Sirois C, Rochette L, Plante C, Larocque I, Doucet M, Ruel G, Simard M, Gamache P, Hamel D, St-Laurent D, Émond V (2014) Quebec Integrated Chronic Disease Surveillance System (QICDSS), an innovative approach. Chronic Dis Inj Can 34(4):226–235

    CAS  PubMed  Google Scholar 

  7. Christodoulou C, Choy EH (2006) Joint inflammation and cytokine inhibition in rheumatoid arthritis. Clin Exp Med 6(1):13–19

    CAS  Article  PubMed  Google Scholar 

  8. Choy EH, Panayi GS (2001) Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med 344(12):907–916

    CAS  Article  PubMed  Google Scholar 

  9. Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81(9):646–656

    PubMed  PubMed Central  Google Scholar 

  10. Haroon N, Aggarwal A, Lawrence A, Agarwal V, Misra R (2007) Impact of rheumatoid arthritis on quality of life. Mod Rheumatol 17(4):290–295

    Article  PubMed  Google Scholar 

  11. Pollard L, Choy EH, Scott DL (2005) The consequences of rheumatoid arthritis: quality of life measures in the individual patient. Clin Exp Rheumatol 23(5 Suppl 39):S43–S52

    CAS  PubMed  Google Scholar 

  12. Widdifield J, Bombardier C, Bernatsky S, Paterson JM, Green D, Young J, Ivers N, Butt DA, Jaakkimainen RL, Thorne JC, Tu K (2014) An administrative data validation study of the accuracy of algorithms for identifying rheumatoid arthritis: the influence of the reference standard on algorithm performance. BMC Musculoskelet Disord 15:216. https://doi.org/10.1186/1471-2474-15-216

    Article  PubMed  PubMed Central  Google Scholar 

  13. Widdifield J, Bernatsky S, Paterson JM, Tu K, Ng R, Thorne JC, Pope JE, Bombardier C (2013) Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists. Arthritis Care Res (Hoboken) 65(10):1582–159191. https://doi.org/10.1002/acr.22031

    Google Scholar 

  14. Ng R, Bernatsky S, Rahme E (2013) Observation period effects on estimation of systemic lupus erythematosus incidence and prevalence in Quebec. J Rheumatol 40(8):1334–1336. https://doi.org/10.3899/jrheum.121215

    Article  PubMed  Google Scholar 

  15. Widdifield J, Paterson JM, Bernatsky S, Tu K, Tomlinson G, Kuriya B, Thorne JC, Bombardier C (2014) The epidemiology of rheumatoid arthritis in Ontario, Canada. Arthritis Rheumatol 66(4):786–793. https://doi.org/10.1002/art.38306

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. National Institute of Public Health of Québec, Québec, Canada

    Sonia Jean & Philippe Gamache

  2. Laval University, Québec, Canada

    Sonia Jean, Louis Bessette & Paul R. Fortin

  3. Jewish General Hospital and Lady Davis Institute for Medical Research, Montréal, Canada

    Marie Hudson

  4. Divisions of Rheumatology and Clinical Epidemiology, McGill University Health Centre, Montréal, Canada

    Marie Hudson & Sasha Bernatsky

  5. Centre hospitalier universitaire de Québec (CHUQ) Research Centre – Centre hospitalier de l’Université Laval (CHUL), Québec, Canada

    Louis Bessette & Paul R. Fortin

  6. University of Sherbrooke, Sherbrooke, Canada

    Gilles Boire

  7. Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, 687 Pine Avenue West, V-Building, Room V2.09, Montreal, Quebec, H3A 1A1, Canada

    Sasha Bernatsky

Authors
  1. Sonia Jean
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marie Hudson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Philippe Gamache
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Louis Bessette
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paul R. Fortin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gilles Boire
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sasha Bernatsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sasha Bernatsky.

Ethics declarations

The creation of this surveillance system was approved by the government bodies in legal possession of the databases, the public health ethics committee, and the Access to Information Office in Quebec.

Disclosures

None.

Additional information

Highlights

• Health administrative data are a potentially efficient resource to conduct population-based research and surveillance, including trends in incidence and mortality over time; our objective was to explore time trends in incidence and mortality for rheumatoid arthritis (RA).

• We found that mortality was substantially higher in RA versus the general population and remained so over the study period. This suggests the need to optimize long-term RA outcomes.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Jean, S., Hudson, M., Gamache, P. et al. Temporal trends in prevalence, incidence, and mortality for rheumatoid arthritis in Quebec, Canada: a population-based study. Clin Rheumatol 36, 2667–2671 (2017). https://doi.org/10.1007/s10067-017-3796-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-017-3796-1

Keywords

  • Administrative data
  • Epidemiology
  • Mortality
  • Rheumatoid arthritis