Background/Purpose: Cardiovascular disease (CVD) is the leading cause of mortality in rheumatoid arthritis (RA), underscoring the importance of CVD prevention. The rates of screening and intervention for modifiable traditional and RA-specific CVD risk factors are low among RA patients. The primary objective of this study was to design and test a web-based educational intervention (EI) for RA patients.

Methods: A 28-minute educational web-based video presentation was designed, recorded on CVD risk specifically for RA patients and pretested. Thirty-eight consecutive consenting RA patients completed onsite EI offered on web. Participants also completed web-based surveys assessing heart disease knowledge, unique heart disease risk factors specific to RA patients, and illness perceptions for CVD as RA patients (HDKQ; HDFQ-RA; IPQ-R) before and after EI. HDKQ and HDFQ-RA were scored using correct response ratios (CRR). Smoking status and sedentary lifestyle were assessed by self-report, whereas chart review was used to ascertain hypertension, diabetes, dyslipidemia, weight, RA control, medication use. General linear model analyses for repeated measures were used to compare within-person changes in CVD risk knowledge post EI.

Results: The participants were 57±13 years old; 77% were women. Cardiac risks were:  21% current smokers, 44% hypertension, 21% diabetes, 63% dyslipidemia, 47% overweight, 45% sedentary, 49% poor RA control; of which 51% reported steroid and/or nonsteroidal anti-inflammatory medication (NSAIDS) use for >15 days within the past 3 months. At study initiation, patients had poor perception of increased CVD risk in context of RA. CRR was ≤ 50% on 8/30 HDKQ domains relating to recognition of CVD symptoms, role of stress, diet and exercise and treatment in CVD. Post EI, significant improvements (Table 1) were evident in 5/8 of these domains (p<0.01). CRR was ≤70% on 3/13 domains on HDFQ-RA, with CRR of 34% and 53% in two domains specifically related to CVD in RA (Table 1). Significant improvements after EI were noted across all three HDFQ-RA domains (p<0.05).

Conclusion: RA patients have poor perception and knowledge of CVD risk associated specifically with RA and RA-related medications. This brief web-based EI increased their awareness about RA-related CVD risk. This may be a step towards mitigating RA related CVD morbidity. Longitudinal study is ongoing. Table 1.