Abstract

Background Screening of hyperlipidemia in rheumatoid arthritis (RA) is suboptimal, despite RA patients’ high risk for cardiovascular disease (CVD) mortality. Objectives To identify barriers to screening for hyperlipidemia among patients with RA from the viewpoint of primary care physicians (PCPs) and rheumatologists. Methods We recruited rheumatologists and PCPs nationally to participate in separate moderated structured group teleconference discussions using the nominal group technique. Participants in each group generated lists of barriers to screening for hyperlipidemia in patients with RA, then each selected the three most important barriers from this list. Results Twenty-six rheumatologists participated in 3 groups and 20 PCPs participated in groups. The resulting barriers were organized into physician-, patient- and system-level barriers. Rheumatologists prioritized physician level barriers (e.g. ‘ownership’ of hyperlipidemia screening), whereas PCPs prioritized patient-level barriers (e.g. complexity of RA itself). See table 1 for details. Conclusion These rheumatologists were conflicted about whether screening of CVD risk among patients with RA should fall within the role of the rheumatologist or PCPs. On the other hand, participating PCPs were concerned about the overall effect of RA and RA treatments in the context of screening hyperlipidemia. Note: RA = rheumatoid arthritis; CVD = cardiovascular disease; 0% = that sub-theme emerged during the brainstorming session but did not receive votes; “ – “ = the sub-theme did not emerge in the respective group. Disclosure of Interests Iris Navarro-Millan: None declared, Anna Cornelius-Schecter: None declared, Ronan O’Beirne Grant/research support from: Pfizer, Inc., Melanie Morris: None declared, Geyanne Lui: None declared, Susan Goodman Grant/research support from: Novartis: research support, Consultant for: Novartis, UCB, Pfizer: consulting, Andrea Cherrington: None declared, Liana Fraenkel: None declared

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