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Quality of Care for Cardiovascular Disease Prevention in Rheumatoid Arthritis : Compliance with Diabetes Screening Guidelines Schmidt, Timothy Joseph; Aviña-Zubieta, J. Antonio; Sayre, E. C.; Abrahamowicz, Michal; Esdaile, John; Lacaille, Diane

Abstract

Objective: To evaluate compliance with diabetes screening guidelines for cardiovascular disease prevention in Rheumatoid Arthritis (RA) compared to the general population. Methods: We conducted the first longitudinal study of a population-based RA cohort including all prevalent RA cases in British Columbia between 1996 and 2006, followed-up until 2010, with matched general population comparators. Using administrative data, we measured compliance with general population guidelines, i.e. testing plasma glucose (PG) at least once every three years after age 45, after excluding individuals with previous diabetes. Follow-up was divided into three-year eligibility periods. Compliance was measured as the proportion of periods with ≥1 PG test performed. OR (95% CI) of compliance in RA (vs. general population) was calculated using GEE models, adjusting for age and sex. Mean compliance rate per patient was also calculated and compared using Mann-Whitney U test. Results: Analysis included 22,624 individuals with RA, contributing 48,724 three-year eligibility periods; and 22,579general population, contributing 51,081 three-year eligibility periods. PG was measured in 72.3% (SD=37%) of the eligible time periods in the RA sample and in 70.4% (SD=38%) for the general population (OR=1.05 [95% CI:1.02;1.09], p<.0001). RA individuals met recommended screening guidelines in 71.4% of their eligible periods, compared to 70.6% (p<.001). Screening improved over time in RA relative to the general population. Family physicians ordered nearly all the PG tests. Conclusion: Compliance with general population guidelines for diabetes screening in RA was suboptimal, with little difference relative to the general population, despite a higher risk of cardiovascular diseases and diabetes.

Item Metadata

Title
Quality of Care for Cardiovascular Disease Prevention in Rheumatoid Arthritis : Compliance with Diabetes Screening Guidelines
Alternate Title
Diabetes Screening in RA
Creator
Schmidt, Timothy Joseph; Aviña-Zubieta, J. Antonio; Sayre, E. C.; Abrahamowicz, Michal; Esdaile, John; Lacaille, Diane
Contributor
Arthritis Research Canada
Date Issued
2018-10
Description
Objective: To evaluate compliance with diabetes screening guidelines for cardiovascular disease prevention in Rheumatoid Arthritis (RA) compared to the general population. Methods: We conducted the first longitudinal study of a population-based RA cohort including all prevalent RA cases in British Columbia between 1996 and 2006, followed-up until 2010, with matched general population comparators. Using administrative data, we measured compliance with general population guidelines, i.e. testing plasma glucose (PG) at least once every three years after age 45, after excluding individuals with previous diabetes. Follow-up was divided into three-year eligibility periods. Compliance was measured as the proportion of periods with ≥1 PG test performed. OR (95% CI) of compliance in RA (vs. general population) was calculated using GEE models, adjusting for age and sex. Mean compliance rate per patient was also calculated and compared using Mann-Whitney U test. Results: Analysis included 22,624 individuals with RA, contributing 48,724 three-year eligibility periods; and 22,579general population, contributing 51,081 three-year eligibility periods. PG was measured in 72.3% (SD=37%) of the eligible time periods in the RA sample and in 70.4% (SD=38%) for the general population (OR=1.05 [95% CI:1.02;1.09], p<.0001). RA individuals met recommended screening guidelines in 71.4% of their eligible periods, compared to 70.6% (p<.001). Screening improved over time in RA relative to the general population. Family physicians ordered nearly all the PG tests. Conclusion: Compliance with general population guidelines for diabetes screening in RA was suboptimal, with little difference relative to the general population, despite a higher risk of cardiovascular diseases and diabetes.
Subject
Rheumatoid arthritis; Comorbidity; Diabetes mellitus; Quality indicators; Cardiovascular diseases; Health services research
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2019-10-01
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0372975
URI
http://hdl.handle.net/2429/67675
Affiliation
Medicine, Faculty of; Other UBC; Non UBC; Medicine, Department of
Citation
Schmidt TJ, Aviña-Zubieta JA, Sayre EC, Abrahamowicz M, Esdaile JM, Lacaille, D. Quality of Care for cardiovascular disease Prevention in RA: Compliance with Diabetes Screening Guidelines. J Rheumatol 2018 Oct;45(10):1367-1374.
Publisher DOI
10.3899/jrheum.170973
Peer Review Status
Reviewed
Scholarly Level
Faculty; Graduate; Other
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International