Table 1

Overview of studies that investigated cardiovascular risk factor screening in patients with rheumatoid arthritis

Author (year)ObjectiveSettingCountryData sourceData selectionNo of patients with RAOutcomes
At least one CVD-RFDesai et al (2012)11 Analyse how frequently traditional CVD-RFs were identified by rheumatologists compared with PCPs in patients with RA in tertiary care centresOutpatient clinic and primary careUSAElectronic patient record systemAll patients251Rheumatologists identified weight in 26.7%, BP in 92.8%, HDL in 5.2% and LDL in 5.6% of the patients with RA. PCPs identified smoking status, weight, lipids and FBG more frequently than rheumatologists in patients with RA
Emanuel et al (2016)12 Identify the extent to which PCPs from one of the most deprived and ethnically diverse areas of the UK implemented recommended guidelines for CVD-RFPrimary careUKElectronic health record databaseAll patients112120% of the patients with RA had one CVD-RF measured within the first 12 months after diagnosis. In 5 years’ follow-up after diagnosis, this percentage increased to 53%
Teir et al (2008)13 Assess whether CVD-RF had been recorded at any time in the preceding year.
Assess clinical CVD-RFs in consecutive outpatients with RA over a year in seven rheumatology units
Outpatient clinicUKElectronic patient record systemRandom sample from total group100At least one CVD-RF was recorded in 146/337 (44%) patients
Monk et al (2013)14 Determine CVD screening practice in RA and comparable non-RA patients prior to the introduction of an incentivised annual review, which includes an assessment of CVD risk.Primary careUKConsultations in Primary Care ArchiveAll patients40187.8% received screening of any one or more of the five factors. 34.4% received screening of BP, smoking and lipids.
24.9% received screening of all five factors.
All five CVD-RFsCompare rates of screening in people with RA with such rates in people with DMIndividuals with DM without RA had over 11 times the odds of receiving a standard CVD screening
Alemao et al (2015)15 Describe the management of traditional CVD risk factors such as lipids, BP and HbA1c in patients with RA in clinical practice settings and compare management with that of matched patients with non-RAPrimary careUKClinical practice databaseAll patients24 859No differences were found between patients with RA and non-RA in terms of the frequency of CVD-RF testing and treatment (no percentages available)
Ikdahl et al (2015)16 Evaluate the rate of CVD-RF recording in a rheumatology outpatient clinic that had implemented the recommendations on annual CVD risk assessment for patients with RAOutpatient clinicNorwayPatients’ journalsSelected group1142Total rate of recording of CVD-RFs was 40.1% and only 26.9% of the patients had a complete risk factor profile
Only lipid testingBarber et al (2016)17 Determine QI performance over a 2-year period, while concurrently assessing the feasibility of identifying the QI from subspecialty medical recordsOutpatient clinicCanadaElectronic and paper patient record systemRandom sample from total group170In 69% of patients, there was a lipid profile determined within 2 years
Bartels et al (2012)18 Examine the influence of primary care visits on the occurrence of annual lipid testingPrimary careUSAMedical Chronic Condition WarehouseSelected group16 893Lipid testing was performed in 63% of the sample patients with RA and comorbid CVD, DM or hyperlipidaemia in whom annual lipid testing was indicated. 1 out of 4 did not see a PCP at least once per year
Jafri et al (2015)19 Determine the prevalence of screening for hyperlipidaemia among patients with RA and describe the characteristics of patients least likely to be screenedPrimary careUSAElectronic patient record systemSelected group141851% of patients received an order for lipid screening within the 3-year follow-up period. Screening was less likely to be performed in patients with an age less than 50
  • BP, blood pressure; CVD, cardiovascular disease; CVD-RF, cardiovascular disease risk factor; DM, diabetes mellitus; FBG, fasting blood glucose; HDL, high density lipoprotein; LDL, low density lipoprotein; PCP, primary care physician; QI, quality indicator; RA, rheumatoid arthritis.