Article Text

Download PDFPDF
Implementation of the EULAR cardiovascular risk management guideline in patients with rheumatoid arthritis: results of a successful collaboration between primary and secondary care
  1. Julia M Weijers1,
  2. Sanne A A Rongen-van Dartel1,2,
  3. Dan M G M F Hoevenaars3,
  4. Max Rubens4,
  5. Marlies E J L Hulscher1,
  6. Piet L C M van Riel1,2
  1. 1 IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
  2. 2 Department of Rheumatology, Bernhoven, Uden, The Netherlands
  3. 3 Synchroon, Uden-Oss-Veghel, The Netherlands
  4. 4 General Practice, Schijndel, The Netherlands
  1. Correspondence to Julia M Weijers, IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen 6500 HB, The Netherlands; julia.weijers{at}


The updated European League Against Rheumatism (EULAR) guideline recommends cardiovascular disease (CVD) risk assessment at least once every 5 years in all patients with rheumatoid arthritis (RA). This viewpoint starts with a literature overview of studies that investigated the level of CVD risk factor (CVD-RF) screening in patients with RA in general practices or in outpatient clinics. These studies indicate that CVD-RF screening in patients with RA is marginally applied in clinical practice, in primary as well as secondary care. Therefore, the second part of this viewpoint describes an example of the successful implementation of the EULAR cardiovascular disease risk management (CVRM) guideline in patients with RA in a region in the south of the Netherlands where rheumatologists and general practitioners (GPs) closely collaborate to manage the cardiovascular risk of patients with RA. The different components of this collaboration and the responsibilities of respectively primary and secondary care professionals are described. Within this collaboration, lipid profile was used as an indicator to assess whether CVD-RF screening was performed in the previous 5 years. In 72% (n=454) of the 628 patients with RA, a lipid profile was determined in the previous 5 years. As part of routine quality control, a reminder was sent to the GP in case a patient with RA was not screened. After sending the reminder letter, in 88% of all patients with RA, CVD risk assessment was performed. This collaboration can be seen as good practice to provide care in line with the EULAR guideline.

  • cardiovascular disease
  • lipids
  • rheumatoid arthritis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Handling editor Josef S Smolen

  • Contributors All authors contributed to the development of this manuscript and approved the final version.

  • Competing interests PvR received grants and personal fees from Pfizer and Abbvie, a grant from UCB and advisory board fees from Eli Lilly.

  • Patient consent Not obtained. Data related to patients were extracted anonymised from the electronic patient record.

  • Ethics approval Committee on Research Involving Human Subjects Arnhem-Nijmegen, The Netherlands. The ethical committee exempted this study from ethical approval because it did not involve research covered by the Medical Research Involving Human Subjects Act.

  • Provenance and peer review Not commissioned; externally peer reviewed.