Patients with rheumatoid arthritis who are at greatest risk for developing cardiovascular disease are largely unaware of the comorbidity, according to recent data in Arthritis Research & Therapy.
“In order to empower patients to become active participants in CVD prevention strategies, an understanding of their awareness regarding CVD is required first,” Olivia R. Ghosh-Swaby, MS, of the Western University Schulich School of Medicine and Dentistry in London, Ontario, Canada, and colleagues wrote. “Little is known about RA patients’ knowledge about the association between RA and CVD, or how their perceived and actual CVD risk may differ.”
To analyze the overall awareness and perceived risk among patients with RA regarding the connection between RA and CVD, Ghosh-Swaby and colleagues conducted a systematic literature search of three electronic databases — Medline, Embase and PubMed. The researchers limited their search to English-language articles published from 1990 to June 20, 2018, featuring observational studies surveying adult populations with RA, with search terms related to RA, CVD, awareness and perceptions of CVD risk.
Two independent reviewers screened a total of 33 abstracts for inclusion or exclusion, of which six were included in the final analysis. These six abstracts provided a sample size of 478 participants, including those with established RA, with a mean age range of 53 to 64 years.
According to Ghosh-Swaby and colleagues, the vast majority of participants, ranging from 73% to 97%, were unaware of the increased risk for CVD associated with RA. In addition, this lack of awareness frequently occurred in patients with RA who demonstrated a greater number of traditional risk factors for CVD.
The researchers also noted that RA disease characteristics linked to CVD, such as the use of disease modifying antirheumatic drugs, corticosteroids or NSAIDs, were not uniformly reported. Misperceptions about CVD were also common, with the majority of participants misestimating their actual individual risk.
“We encourage additional studies and pragmatic trials of RA-specific educational interventions to be conducted,” Ghosh-Swaby and colleagues wrote. “These will help determine if knowledge gains are sustainable and have substantive impact on long-term CVD outcomes in RA. However, based on our findings, these interventions must be flexible in format, be designed with the input of content experts, including patients themselves and, above all, be tailored to meet the needs of patients.”
“A deeper understanding of the system-, physician-, and patient-level barriers preventing optimal awareness of this comorbidity is also needed,” the researchers added. “Only then will interventions to improve CVD screening and management in RA be truly successful.” – by Jason Laday
Disclosure: Ghosh-Swaby reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.