Rheumatologist and Primary Care Management of Cardiovascular Disease Risk in Rheumatoid Arthritis: Patient and Provider Perspectives

Arthritis Care & Research
Christie M BartelsBarbara J Bowers

Abstract

Despite increased cardiovascular disease (CVD) risk, rheumatoid arthritis (RA) patients often lack CVD preventive care. We examined CVD preventive care processes from RA patient and provider perspectives to develop a process map for identifying targets for future interventions to improve CVD preventive care. Thirty-one participants (15 patients, 7 rheumatologists, and 9 primary care physicians [PCPs]) participated in interviews that were coded using NVivo software and analyzed using grounded theory techniques. Patients and providers reported that receipt of preventive care depends upon identifying and acting on risk factors, although most noted that both processes rarely occurred. Engagement in these processes was influenced by various provider-, system-, visit-, and patient-related conditions, such as patient activation or patients' knowledge about their risk. While nearly half of patients and PCPs were unaware of RA-CVD risk, all rheumatologists were aware of risk. Rheumatologists reported not systematically identifying risk factors, or, if identified, they described communicating about CVD risk factors via clinic notes to PCPs instead of acting directly due to perceived role boundaries. PCPs suggested that scheduling PCP vis...Continue Reading

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Citations

Apr 1, 2017·Current Rheumatology Reports·Ann M ChodaraChristie M Bartels
Jul 13, 2017·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Andrew P VreedeChristie M Bartels
Apr 25, 2018·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Christie Michels BartelsMaureen Smith
Sep 11, 2018·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Darcy S MajkaStephen D Persell
Jul 17, 2018·The Journal of Rheumatology·Timothy J SchmidtDiane Lacaille
Aug 15, 2018·Arthritis Care & Research·Mehret Birru TalabiSonya Borrero
Nov 11, 2018·Arthritis Care & Research·Iris Navarro-MillánJeffrey R Curtis
Apr 22, 2020·ACR Open Rheumatology·Shubhasree BanerjeeJoel M Kremer
Feb 16, 2019·Arthritis Care & Research·Aimée WattiauxChristie M Bartels
Sep 25, 2020·Rheumatology Advances in Practice·Keegan KnittleGill Ten Hoor
Jun 16, 2021·Journal of Interprofessional Care·Bryn L SutherlandMeghan B Brennan

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