Oklahoma researchers and tribal clinic doctors are together to combat a disease that affects a high rate of American Indians.
Researchers at the Oklahoma Medical Research Foundation have formed a partnership with doctors at Chickasaw Nation and Cherokee Nation clinics to provide care for rheumatoid arthritis and other autoimmune diseases.
At the same time, the medical foundation enrolls patients at the clinic in research that helps them better understand, for example, why four times as many American Indians are affected by rheumatoid arthritis than those of European ancestry.
Rheumatoid arthritis is a form of arthritis that causes pain, swelling, stiffness and loss of function in a person's joints, according to the National Institutes of Health. It affects an estimated 1.5 million adults.
Dr. Judith James, a scientist at Oklahoma Medical Research Foundation, has been going to the Chickasaw and Cherokee clinics for about seven years.
So far, about 200 tribe members with rheumatic diseases and 200 healthy control subjects have been enrolled in research about rheumatoid arthritis and other autoimmune diseases. Through the partnership, James and her fellow doctors and researchers have created new screening techniques for diagnosing rheumatoid arthritis.
“By raising awareness about rheumatic diseases in our tribal members, I think that has helped not just the providers in the clinics but also all of the staff and pharmacists and everybody understand that the rheumatic diseases are really common in our tribal members, and it is helping them find ways to get access to the resources they need to treat their diseases,” James said.
It's harder to diagnose American Indian patients with these diseases. That's because the typical blood test often times doesn't work to diagnose American Indian patients.
Whenever a patient undergoes a blood test, the doctor is looking for certain blood markers that signal which disease the patient might have. But the blood markers that doctors use to diagnose certain autoimmune diseases aren't as reliable in diagnosing some American Indian patients.
“It may not work nearly as well in people who are of Cherokee or Chickasaw decent,” James said. “It makes it harder to diagnose, it delays diagnosis, which means it delays treatment.”
Another obstacle in diagnosis is in finding a rheumatologist in Oklahoma. The state faces a shortage, needing an additional 12 to 20 more rheumatologists, James said.
A rheumatologist is an internist or pediatrician who received further training in the diagnosis and treatment of arthritis and other musculoskeletal diseases, according to the American College of Rheumatology.
But the partnership also has helped doctors at the tribal clinics learn more about rheumatic diseases, helping make that shortage less of an issue.
“We value our partnership with Dr. James and, as a result, have improved the lives of hundreds of patients,” Dr. Fabio Mota, chief of internal medicine at the Chickasaw Nation Medical Center, said in a statement. “These patients are receiving the best treatment available not only in the state of Oklahoma but in the world.”