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Gaps in addressing cardiovascular risk in rheumatoid arthritis : assessing performance using cardiovascular quality indicators Barber, Claire E. H.; Esdaile, John; Martin, Liam; Faris, Peter; Barnabe, Cheryl; Guo, Selynne; Lopatina, Elena; Marshall, Deborah
Abstract
Objectives: Cardiovascular disease (CVD) is a major comorbidity for patients with rheumatoid arthritis (RA). The study sought to determine performance on 11 recently developed CVD Quality Indicators (QIs) for RA in clinical practice. Methods: Medical charts for RA patients (early disease or biologic-treated) followed at one centre were retrospectively reviewed. A systematic assessment of adherence to 11 QIs over a two-year period was completed. Performance on the QIs is reported as a percentage pass rate. Results: 170 charts were reviewed (107 early disease and 63 biologictreated). The most frequent CVD risk factors present at diagnosis (early disease) and biologic start (biologictreated) included hypertension (26%), obesity (25%), smoking (21%) and dyslipidemia (15%). Performance on the CVD QIs was highly variable. Areas of low performance (<10% pass rates) included documentation of a formal CVD risk assessment, communication to the primary care provider that patients with RA are at increased risk of CVD, body mass index documentation and counselling if overweight, communication to a primary care provider about an elevated blood pressure, and discussion of risks and benefits of anti-inflammatories in patients at CVD risk. Rates of diabetes screening and lipid screening were 67 and 69% respectively. The area of highest performance was observed for documentation of intent to taper corticosteroid (98-100% for year 1 and 2 respectively). Conclusions: Gaps in CVD risk management were found and highlight the need for quality improvements. Key targets for improvement include coordination of CVD care between rheumatology and primary care and communication of increased CVD risk in RA.
Item Metadata
| Title |
Gaps in addressing cardiovascular risk in rheumatoid arthritis : assessing performance using cardiovascular quality indicators
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| Creator | |
| Date Issued |
2016-11
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| Description |
Objectives: Cardiovascular disease (CVD) is a major comorbidity for patients with rheumatoid arthritis (RA). The study sought to determine performance on 11 recently developed CVD Quality Indicators (QIs) for RA in clinical practice.
Methods: Medical charts for RA patients (early disease or biologic-treated) followed at one centre were retrospectively reviewed. A systematic assessment of adherence to 11 QIs over a two-year period was completed. Performance on the QIs is reported as a percentage pass rate.
Results: 170 charts were reviewed (107 early disease and 63 biologictreated). The most frequent CVD risk factors present at diagnosis (early disease) and biologic start (biologictreated) included hypertension (26%), obesity (25%), smoking (21%) and dyslipidemia (15%). Performance on the CVD QIs was highly variable. Areas of low performance (<10% pass rates) included documentation of a formal CVD risk assessment, communication to the primary care provider that patients with RA are at increased risk of CVD, body mass index documentation and counselling if overweight, communication to a primary care provider about an elevated blood pressure, and discussion of risks and benefits of anti-inflammatories in patients at CVD risk. Rates of diabetes screening and
lipid screening were 67 and 69% respectively. The area of highest performance was observed for documentation of intent to taper corticosteroid (98-100% for year 1 and 2 respectively).
Conclusions: Gaps in CVD risk management were found and highlight the need for quality improvements. Key targets for improvement include coordination of CVD care between rheumatology and primary care and communication of increased CVD risk in RA.
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| Subject | |
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| Type | |
| Language |
eng
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| Date Available |
2018-12-17
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| Provider |
Vancouver : University of British Columbia Library
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| Rights |
Attribution-NonCommercial-NoDerivatives 4.0 International
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| DOI |
10.14288/1.0375752
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| URI | |
| Affiliation | |
| Citation |
Barber CE, Esdaile JM, Martin LO, Faris P, Barnabe C, Guo S, Lopatina E, Marshall DA. Gaps in addressing cardiovascular risk in rheumatoid arthritis: assessing performance using cardiovascular quality indicators. J Rheumatol. 2016 Nov;43(11):1965-1973.
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| Publisher DOI |
10.3899/jrheum.160241
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| Peer Review Status |
Reviewed
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| Scholarly Level |
Faculty
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| Rights URI | |
| Aggregated Source Repository |
DSpace
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Rights
Attribution-NonCommercial-NoDerivatives 4.0 International