Outreach to Promote Management of Cardiovascular Risk in Primary Care Among Patients With Rheumatoid Arthritis Seen...

Area of Science:

• Cardiology
• Rheumatology
• Public Health

Background:

• Rheumatoid arthritis (RA) significantly increases cardiovascular disease (CVD) risk.
• Previous quality improvement initiatives failed to improve CVD risk factor management in RA patients.
• A novel strategy was needed to enhance CVD preventive care within rheumatology practices.

Purpose of the Study:

• To evaluate the effectiveness of a proactive outreach strategy promoting primary care-based CVD risk factor treatment for RA patients.
• To assess the impact of this intervention on statin therapy, hypertension management, and smoking cessation.

Main Methods:

• Electronic health records identified RA patients eligible for interventions (hypertension, statins, smoking cessation).
• A nonclinician care manager contacted patients and their primary care physicians (PCPs), facilitating follow-up and treatment.
• Interrupted time series analysis compared quality indicators before and during the intervention.

Main Results:

• Statin prescribing for primary prevention increased significantly (18.4% to 23.8%) during the 6-month intervention.
• Hypertension diagnosis and control rates improved more rapidly, reversing prior negative trends.
• The intervention did not demonstrate a significant effect on smoking cessation rates.

Conclusions:

• Proactive nonclinician outreach can effectively enhance CVD risk factor management in RA patients.
• This strategy led to increased statin prescribing and improved hypertension control.
• Further interventions are needed to address smoking cessation in this population.