Background The Rheumatoid Arthritis (RA) is associated with an increased cardiovascular risk. While the rheumatologists have made progress in the control of the inflammatory process, control of comorbidities associated with RA, as cardiovascular risk factors, does not usually take place in daily clinical practice. Identification and control of these risk factors depends in large part on primary care physicians. The close monitoring of patients with RA by the rheumatologist makes sometimes primary care physicians forget certain practices that would be performed routinely in patients without a rheumatic disease. The lack of connection between data of primary and specialized care often results in test duplication.
Objectives Identify the level of agreement according to the cardiovascular risk factors between data registered in hospital medical records and those registered in primary care medical records.
Methods This is a cross-sectional study of a random population of 217 patients with RA, according to the 1987 ACR criteria. A systematic review of 217 medical histories of patients with RA followed by the Rheumatology Unit of the Hospital of Sabadell was done. Some demographic data were collected as gender, age, concomitant use of biological agents and presence of the following cardiovascular risk factors: hypertension, diabetes, dyslipidemia, hyperuricemia, obesity and smoking habit (present or past). The same data were studied in the medical records of the primary health care.Then compared the differences between both results.
Results The hospital medical histories of 217 RA patients were analysed, and compared to the medical histories of primary care. In 25 cases the comparison could not be done because the impossibility of the access to the primary care records. Patients were classified into different groups according to the number of cardiovascular risk factors they had (from one to six). It was noted that in the hospital records 35% of the patients had at least two cardiovascular risk factors, while the remaining 65% had one or none. On the other hand, in the primary care records the percentage of patients with two or more cardiovascular risk factors reached 42%. The comparison of all the records shows that both registers only agree on the number of cardiovascular risk factors in 32% of the cases. In 38% the number of risk factors set out in the hospital is greater than in primary care, while in 30% is higher in primary care.
Conclusions Data registered in records of specialized care are different from those belonging to primary care. The lines of communication between specialized and primary care should be improved in order to optimize treatment of comorbidities an avoid duplication of studies and additional tests. The rheumatologist is a provider of health in patients with RA, and must assist in the diagnosis and treatment of the multiple comorbidities associated to RA with the support of the primary care physician to avoid duplication.
Disclosure of Interest None Declared
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