Background Patients with Rheumatoid Arthritis (RA) have an elevated cardiovascular (CV) risk, comparable to the risk in type 2 diabetes mellitus. Recent guidelines suggest strict treatment of CV risk factors. It is well known that adherence to primary preventive interventions is frequently suboptimal (around 50%).
Objectives To evaluate the self-reported adherence to CV prevention strategies by patients with RA participating in the FRANCIS study, a long term, randomized, single centre intervention study investigating the need for strict CV prevention strategies in RA.
Methods Included RA patients who were randomized to strict CV risk prevention strategies received a validated questionnaire to evaluate adherence to therapy. All patients followed a structured CV risk management program with rheumatologists, vascular specialists, dieticians and specialized nurses for vascular and RA care. Strict treatment targets were defined and lifestyle recommendations, antihypertensive and lipid lowering drugs were prescribed following a pre-specified protocol. Questionnaires were sent to patients who had had at least two visits to our outpatient clinic and a minimum of 6 months follow up. CV risk was assessed using the SCORE algorithm
Results Questionnaires were sent to 136 patients (response rate 111 (82%)). A high CV risk (≥20%) was found in 60 (53%) patients, but only 3 (3%) thought that they had an increased CV risk. In total, 65 (69%) patients followed the doctors' suggestions exactly and 71 (75%) patients found it easy to follow their doctors suggestions exactly. From the 71 (66%) patients who were prescribed medication, 59 (83%) took all prescribed tablets. Dietary measures were advised to 46 (42%) patients and 30 (66%) said to adhere to the diet. Physical exercise was ad vised to 72 (66%) patients and 42 (58%) said to perform specific physical exercise ≥3 days/week. The adherence was not significantly different between patients with a CV risk <10%, 10%>20% and/or >20%.
Conclusions RA patients tend to underestimate their CV risk. Self-reported treatment adherence is 70%, being suboptimal. The adherence to recommendations is not associated to patients true CV risk. Better patient awareness of their CV risk is necessary to improve adherence.
Disclosure of Interest None declared