Methods: We recruited rheumatologists and PCPs nationally to participate in moderated, structured group teleconference discussions using the nominal group technique. The groups had either only PCPs or only rheumatologists. Participants generated lists of barriers to screening and management for hyperlipidemia in patients with RA, within the same session. Each participant was allowed 6 votes to rank items: 3 votes for the most important item, 2 for the second most important, and 1 to the third most important. Investigators characterized items and totaled the votes as themes and sub-themes.

Results: Twenty-six rheumatologists participated in 1 of 3 groups (group size ranged from 7-11) and 22 PCPs participated in 1 of 3 groups (group size ranged from 4-9). The items generated across the 6 separate groups were categorized into physician-, patient- and system-level barriers. Table 1 lists the barriers for hyperlipidemia screening and Table 2 lists the barriers for management of hyperlipidemia for both rheumatologists and PCPs.

The largest number of barriers for rheumatologists were at the physician level (e.g. ‘ownership’ of hyperlipidemia screening and management), with 83% of the priority votes for screening and 89% for treatment. Patient-level barriers received the majority of votes among the PCPs groups (44% for screening and 69% for management).