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Patterns of preventive health services in rheumatoid arthritis patients compared to a primary care patient population

Rheumatology International volume 31, pages 1159–1165 (2011)Cite this article

Abstract

To determine the proportion of rheumatoid arthritis (RA) patients receiving preventive health care according to US Preventive Services Task Force recommendations compared with a community-based population sample, with emphasis on dyslipidemia testing, given the increased risk of cardiovascular disease (CVD) in RA patients. Patients with RA (ICD-9 code 714.0 at ≥2 office visits with a rheumatologist) and a primary care physician (PCP) at the Geisinger Health System (GHS) were identified through electronic health records. The records were searched back from 3/31/08 for the length of time required to satisfy each outcome measure. Percentages were compared with population testing rates using the Pearson Chi-square test. Eight hundred and thirty-one RA patients were compared to 169,476 subjects with a PCP at GHS, stratified by gender and age. Patients with RA were more likely to have had dyslipidemia and osteoporosis testing compared with the general population (86 vs. 75 and 75 vs. 55%, respectively, P < 0.0001 for both). The proportion of RA patients receiving breast and cervical cancer testing was similar to the general population. The majority (79%) of lipid testing was ordered by PCPs. Those RA patients with recommended lipid testing had more traditional CVD factors (hypertension, diabetes, coronary artery disease). RA patients are screened more than the general population for two RA-related co-morbidities, i.e. dyslipidemia and osteoporosis. The RA patients with traditional cardiovascular risk factors are more likely to be tested for dyslipidemia. Further work is warranted to improve testing for modifiable CVD risk factors in this group with multiple co-morbidities.

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Acknowledgments

Institutional support. No grant or industrial support.

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Affiliations

  1. Geisinger Health System, 100N. Academy Avenue, MC 13-41, Danville, PA, 17822, USA

    Androniki Bili, Lisa L. Schroeder, Lindsay J. Ledwich & Eric D. Newman

  2. Geisinger Center for Health Research, Geisinger, PA, USA

    H. Lester Kirchner

  3. Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Mary Chester M. Wasko

Authors
  1. Androniki Bili
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  2. Lisa L. Schroeder
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  3. Lindsay J. Ledwich
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  4. H. Lester Kirchner
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  5. Eric D. Newman
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  6. Mary Chester M. Wasko
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Correspondence to Androniki Bili.

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Bili, A., Schroeder, L.L., Ledwich, L.J. et al. Patterns of preventive health services in rheumatoid arthritis patients compared to a primary care patient population. Rheumatol Int 31, 1159–1165 (2011). https://doi.org/10.1007/s00296-010-1461-y

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  • DOI: https://doi.org/10.1007/s00296-010-1461-y

Keywords

  • Rheumatoid arthritis
  • Preventive services
  • Lipids
  • Osteoporosis