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Changes in Care After Implementing a Multifaceted Intervention to Improve Preventive Cardiology Practice in

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An intervention improved cardiovascular disease (CVD) risk factor assessment in rheumatoid arthritis (RA) patients. However, it did not enhance CVD risk factor management or control, indicating a need for new strategies.

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Area of Science:

  • Rheumatology
  • Cardiology
  • Public Health

Background:

  • Rheumatoid arthritis (RA) is associated with increased cardiovascular disease (CVD) risk.
  • Inadequate identification and treatment of CVD risk factors in RA patients is a significant clinical challenge.

Purpose of the Study:

  • To implement and evaluate a multifaceted intervention aimed at improving CVD risk factor measurement, assessment, and management within rheumatology practices.
  • To enhance the quality of care for RA patients regarding CVD prevention.

Main Methods:

  • A multifaceted intervention involving clinician education, point-of-care decision support, feedback, and care management was implemented.
  • Quality indicators were measured using electronic health records.
  • The impact of the intervention was assessed using interrupted time series analysis.

Main Results:

  • The proportion of RA patients with all major CVD risk factors assessed significantly increased post-intervention (53% to 72.2%).
  • The rate of increase in CVD risk factor assessment was significantly higher during the intervention period compared to baseline (0.74% per month, P = .0016).
  • Moderate- or high-intensity statin prescribing increased, but the rate of change was not statistically different from baseline; other quality measures did not improve.

Conclusions:

  • The intervention successfully improved the assessment of CVD risk factors in RA patients.
  • The intervention did not significantly impact the management and control of CVD risk factors.
  • Additional strategies are required to optimize cardiovascular disease prevention in individuals with rheumatoid arthritis.