Participation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritis
Abstract Background In accordance with the EULAR recommendations, the Danish Hospital for Rheumatic Diseases have systematically invited patients with rheumatoid arthritis (RA) to cardiovascular (CV) risk assessment since 2011. Patients with high risk are invited to a follow-up screening after one y...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Rheumatology |
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| Online Access: | https://doi.org/10.1186/s41927-024-00378-7 |
| _version_ | 1827325855167152128 |
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| author | Julie Katrine Karstensen Ann Bremander Jeanette Reffstrup Christensen Jette Primdahl |
| author_facet | Julie Katrine Karstensen Ann Bremander Jeanette Reffstrup Christensen Jette Primdahl |
| author_sort | Julie Katrine Karstensen |
| collection | DOAJ |
| description | Abstract Background In accordance with the EULAR recommendations, the Danish Hospital for Rheumatic Diseases have systematically invited patients with rheumatoid arthritis (RA) to cardiovascular (CV) risk assessment since 2011. Patients with high risk are invited to a follow-up screening after one year. To optimize the screening and tailor it to individual needs, information about who accepts vs. declines follow-up is needed. Thus, the aim of this study was to explore participation in systematic CV risk assessment among patients with RA. Furthermore, to explore differences between patients with low vs. high risk, and between patients with high risk who accept vs. decline follow-up. Methods Data from 2,222 outpatients with RA in the period 2011-2021 were retrieved, and of these 1,522 were under 75 years and eligible to be invited. To assess the 10-year risk for CV death, the modified Systematic Coronary Risk Evaluation (mSCORE), derived by multiplying the SCORE by 1.5, was used. Logistic regression analyses were used to explore differences in CV risk factors (triglycerides, HbA1c, lifestyle factors) and measures of disease impact (pain, fatigue, patient global assessment, HAQ, EQ-5D-5L) between patients with low vs. high risk. Differences between high risk patients who accepted vs. declined follow-up were analysed using Wilcoxon rank sum test and chi-squared test for groups. Results One thousand one hundred forty-nine received a CV screening invitation and 91 declined participation. Patients with high risk had significantly longer disease duration (OR; 95 CI) (1.017; 1.002-1.032), higher levels of triglycerides (1.834; 1.475-2.280), HbA1C (1.046; 1.020-1.070), pain (1.006; 1.001-1.012), and HAQ-score (1.305; 1.057-1.612) compared to patients with low risk and they more often declined follow-up (43% vs. 28%, p < 0.001). Those who declined a follow-up invitation were older (p = 0.016) and had shorter disease duration (p = 0.006) compared to those who accepted follow-up. Conclusion A first CV screening consultation was accepted by most patients with RA, while only every other patient with high to very high CV risk adhered to a follow-up screening consultation. Neither measures of disease impact nor lifestyle factors were associated with adherence. Further studies are needed to explore the patients' motivation, barriers and facilitators for adherence or non-adherence to a follow-up consultation. |
| first_indexed | 2024-03-07T14:35:23Z |
| format | Article |
| id | doaj.art-e3b3fbded571414a8bd6ad9a02a98843 |
| institution | Directory Open Access Journal |
| issn | 2520-1026 |
| language | English |
| last_indexed | 2024-03-07T14:35:23Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Rheumatology |
| spelling | doaj.art-e3b3fbded571414a8bd6ad9a02a988432024-03-05T20:41:15ZengBMCBMC Rheumatology2520-10262024-02-018111110.1186/s41927-024-00378-7Participation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritisJulie Katrine Karstensen0Ann Bremander1Jeanette Reffstrup Christensen2Jette Primdahl3Department of Regional Health Research, University of Southern DenmarkDepartment of Regional Health Research, University of Southern DenmarkResearch Unit of General Practice, Department of Public Health, University of Southern DenmarkDepartment of Regional Health Research, University of Southern DenmarkAbstract Background In accordance with the EULAR recommendations, the Danish Hospital for Rheumatic Diseases have systematically invited patients with rheumatoid arthritis (RA) to cardiovascular (CV) risk assessment since 2011. Patients with high risk are invited to a follow-up screening after one year. To optimize the screening and tailor it to individual needs, information about who accepts vs. declines follow-up is needed. Thus, the aim of this study was to explore participation in systematic CV risk assessment among patients with RA. Furthermore, to explore differences between patients with low vs. high risk, and between patients with high risk who accept vs. decline follow-up. Methods Data from 2,222 outpatients with RA in the period 2011-2021 were retrieved, and of these 1,522 were under 75 years and eligible to be invited. To assess the 10-year risk for CV death, the modified Systematic Coronary Risk Evaluation (mSCORE), derived by multiplying the SCORE by 1.5, was used. Logistic regression analyses were used to explore differences in CV risk factors (triglycerides, HbA1c, lifestyle factors) and measures of disease impact (pain, fatigue, patient global assessment, HAQ, EQ-5D-5L) between patients with low vs. high risk. Differences between high risk patients who accepted vs. declined follow-up were analysed using Wilcoxon rank sum test and chi-squared test for groups. Results One thousand one hundred forty-nine received a CV screening invitation and 91 declined participation. Patients with high risk had significantly longer disease duration (OR; 95 CI) (1.017; 1.002-1.032), higher levels of triglycerides (1.834; 1.475-2.280), HbA1C (1.046; 1.020-1.070), pain (1.006; 1.001-1.012), and HAQ-score (1.305; 1.057-1.612) compared to patients with low risk and they more often declined follow-up (43% vs. 28%, p < 0.001). Those who declined a follow-up invitation were older (p = 0.016) and had shorter disease duration (p = 0.006) compared to those who accepted follow-up. Conclusion A first CV screening consultation was accepted by most patients with RA, while only every other patient with high to very high CV risk adhered to a follow-up screening consultation. Neither measures of disease impact nor lifestyle factors were associated with adherence. Further studies are needed to explore the patients' motivation, barriers and facilitators for adherence or non-adherence to a follow-up consultation.https://doi.org/10.1186/s41927-024-00378-7Health behaviourCardiovascular risk assessmentCardiovascular risk managementRheumatoid arthritis |
| spellingShingle | Julie Katrine Karstensen Ann Bremander Jeanette Reffstrup Christensen Jette Primdahl Participation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritis BMC Rheumatology Health behaviour Cardiovascular risk assessment Cardiovascular risk management Rheumatoid arthritis |
| title | Participation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritis |
| title_full | Participation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritis |
| title_fullStr | Participation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritis |
| title_full_unstemmed | Participation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritis |
| title_short | Participation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritis |
| title_sort | participation in cardiovascular screening consultations the who when and why a cohort study on patients with rheumatoid arthritis |
| topic | Health behaviour Cardiovascular risk assessment Cardiovascular risk management Rheumatoid arthritis |
| url | https://doi.org/10.1186/s41927-024-00378-7 |
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