Cardiovascular risk management in rheumatoid arthritis: A large gap to close
| Autor: | Matthew Clifford-Rashotte, Ameen Patel, Mark Matsos, Karim Ladak, Vikas Tandon, Jomana Hashim |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Nursing (miscellaneous) Cardiovascular risk factors Physical Therapy Sports Therapy and Rehabilitation Primary care 030204 cardiovascular system & hematology Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Rheumatology Risk Factors Internal medicine Diabetes mellitus medicine Diabetes Mellitus Humans Orthopedics and Sports Medicine Intensive care medicine Cardiac risk Risk management Aged Dyslipidemias Retrospective Studies 030203 arthritis & rheumatology business.industry Rehabilitation Middle Aged medicine.disease Cardiovascular Diseases Rheumatoid arthritis Hypertension Female Chiropractics Guideline Adherence business Risk assessment |
| Zdroj: | Musculoskeletal care. 16(1) |
| ISSN: | 1557-0681 |
| Popis: | OBJECTIVE Rheumatoid arthritis (RA) portends significant cardiovascular morbidity and mortality. We therefore determined how often rheumatologists screened for and managed cardiovascular risk factors in RA patients, and the barriers to doing so. METHODS We examined 300 patient charts from 10 university-affiliated rheumatology practices, to ascertain if they had been screened, treated and/or referred over a 3-year period. We subsequently distributed a national survey to Canadian rheumatologists to elucidate challenges in performing optimal cardiovascular risk modification. RESULTS Most patients were screened for hypertension. Forty-one per cent were found to be hypertensive; however, the majority of these patients were neither treated nor referred to another provider for management. A small minority of patients were screened for diabetes and/or hyperlipidaemia, and these were usually not addressed if abnormal. Men were referred more frequently than women. Consistent with these findings, the majority of rheumatologists from the national survey felt that they did not manage cardiovascular risk adequately; 79.4% cited a lack of time as a major barrier, and 82.5% felt that it should be managed by the primary care provider. CONCLUSION There is marked underdiagnosis and undertreatment of cardiac risk in RA. Several major barriers exist, including lack of time. Most rheumatologists feel that this aspect of care is the responsibility of primary care physicians. |
| Databáze: | OpenAIRE |
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