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Low frequency of primary lipid screening among medicare patients with rheumatoid arthritis.

Publication ,  Journal Article
Bartels, CM; Kind, AJH; Everett, C; Mell, M; McBride, P; Smith, M
Published in: Arthritis and rheumatism
May 2011

Although studies have demonstrated suboptimal preventive care in RA patients, performance of primary lipid screening (i.e., testing before cardiovascular disease [CVD], CVD risk equivalents, or hyperlipidemia is evident) has not been systematically examined. The purpose of this study was to examine associations between primary lipid screening and visits to primary care providers (PCPs) and rheumatologists among a national sample of older RA patients.This retrospective cohort study examined a 5% Medicare sample that included 3,298 RA patients without baseline CVD, diabetes mellitus, or hyperlipidemia, who were considered eligible for primary lipid screening during the years 2004-2006. The outcome was probability of lipid screening by the relative frequency of primary care and rheumatology visits, or seeing a PCP at least once each year.Primary lipid screening was performed in only 45% of RA patients. Overall, 65% of patients received both primary and rheumatology care, and 50% saw a rheumatologist as often as a PCP. Any primary care predicted more lipid screening than lone rheumatology care (26% [95% confidence interval (95% CI) 21-32]). As long as a PCP was involved, performance of lipid screening was similar regardless of the balance between primary and rheumatology visits (44-48% [95% CI 41-51]). Not seeing a PCP at least annually decreased screening by 22% (adjusted risk ratio 0.78 [95% CI 0.71-0.84]).Primary lipid screening was performed in fewer than half of eligible RA patients, highlighting a key target for CVD risk reduction efforts. Annual visits to a PCP improved lipid screening, although performance remained poor (51%). Half of RA patients saw their rheumatologist as often or more often than they saw a PCP, illustrating the need to study optimal partnerships between PCPs and rheumatologists for screening patients for CVD risks.

Duke Scholars

Published In

Arthritis and rheumatism

DOI

EISSN

1529-0131

ISSN

0004-3591

Publication Date

May 2011

Volume

63

Issue

5

Start / End Page

1221 / 1230

Related Subject Headings

  • United States
  • Rheumatology
  • Retrospective Studies
  • Primary Health Care
  • Medicare
  • Mass Screening
  • Male
  • Lipids
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bartels, C. M., Kind, A. J. H., Everett, C., Mell, M., McBride, P., & Smith, M. (2011). Low frequency of primary lipid screening among medicare patients with rheumatoid arthritis. Arthritis and Rheumatism, 63(5), 1221–1230. https://doi.org/10.1002/art.30239
Bartels, Christie M., Amy J. H. Kind, Christine Everett, Matthew Mell, Patrick McBride, and Maureen Smith. “Low frequency of primary lipid screening among medicare patients with rheumatoid arthritis.Arthritis and Rheumatism 63, no. 5 (May 2011): 1221–30. https://doi.org/10.1002/art.30239.
Bartels CM, Kind AJH, Everett C, Mell M, McBride P, Smith M. Low frequency of primary lipid screening among medicare patients with rheumatoid arthritis. Arthritis and rheumatism. 2011 May;63(5):1221–30.
Bartels, Christie M., et al. “Low frequency of primary lipid screening among medicare patients with rheumatoid arthritis.Arthritis and Rheumatism, vol. 63, no. 5, May 2011, pp. 1221–30. Epmc, doi:10.1002/art.30239.
Bartels CM, Kind AJH, Everett C, Mell M, McBride P, Smith M. Low frequency of primary lipid screening among medicare patients with rheumatoid arthritis. Arthritis and rheumatism. 2011 May;63(5):1221–1230.
Journal cover image

Published In

Arthritis and rheumatism

DOI

EISSN

1529-0131

ISSN

0004-3591

Publication Date

May 2011

Volume

63

Issue

5

Start / End Page

1221 / 1230

Related Subject Headings

  • United States
  • Rheumatology
  • Retrospective Studies
  • Primary Health Care
  • Medicare
  • Mass Screening
  • Male
  • Lipids
  • Humans
  • Female