System integration and clinical utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) program - trained extended role practitioners in Ontario: a two-year, system-level evaluation

Background: The Advanced Clinician Practitioner in Arthritis Care (ACPAC) program was developed in 2005 to prepare experienced physical and occupational therapists to function as extended role practitioners (ERPs) within models of arthritis care across Ontario, Canada.Purpose: To examine the system-level integration and clinical utilization of the ACPAC program-trained ERP.Method: A longitudinal survey was administered to all ACPAC graduates over a two-year period (n=30).Results: The majority of ERPs were physical therapists working in urban settings. Family physicians or physician specialists referred the majority of patients. The longest median wait time to access ERPs' services was 22 days. Half of the ERPs triaged patients, and most of those who did triage (75%) worked under medical directives. Approximately half (51.6%) of the patients seen had a diagnosis of osteoarthritis, followed by rheumatoid arthritis (14.7%).Conclusion: Understanding the system-level impact of this unique human resource can help to shape healthcare planning and delivery of care.