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Abstract Number: 1482

Web-Based PILOT Intervention Study to Improve Cardiovascular Risk Knowledge Among Rheumatoid Arthritis Patients

Meenakshi Jolly1, Eleftheria Steinig2, Lisa Walt3 and Rasa Kazkauskaite4, 1Rush, Chicago, IL, 2Division of Rheumatology, Rush University Medical Center, Chicago, IL, 3Rush University, Chicago, IL, 4Rush University, chicago, IL

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Cardiovascular disease, Education, internet and rheumatoid arthritis (RA), patient

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Session Information

Date: Monday, November 14, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster II: Co-morbidities and Complications

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

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.

Item Heart Disease Knowledge Questionnaire Pre Post Within person
    N=38 N=38  
  (Correct response ratio) EMM*, SE EMM,SE P value

7

 The most important cause of 0.37,0.08 0.55,0.08

0.006

  heart attacks is stress.      

8

Walking and gardening are 0.97,0.03 0.90,0.05

0.08

  considered types of exercise than      
  can lower heart disease risk.      

9

 Most of the cholesterol in an egg 0.95,0.04 0.89,0.06

0.08

  is in the white part of the egg.      

14

The healthiest exercise for the 0.34,0.08 0.50,0.08

0.03

  heart involves rapid breathing for      
  a sustained period of time.      

19

 HDL refers to "good" cholesterol, 0.58,0.08 0.90,0.05

<0.001

  and LDL refers to "bad"      
  cholesterol.      

25

Margarine with liquid safflower oil 0.24,0.07 0.50,0.08

0.003

  is healthier than margarine with      
  hydrogenated soy oil.      

27

 Men and women experience 0.29,0.08 0.53,0.08

0.005

  many of the same symptoms of a      
  heart attack.      
Item Heart Disease Fact Questionnaire-RA Pre Post Within person
    N=38 N=38  
  (Correct response ratio) EMM*, SE EMM,SE P value
         

8

A person with diabetes is more 0.68,0.08 0.87,0.06

0.050

  likely to develop heart disease      

12

Anti-inflammatory medications, 0.34,0.08 0.71,0.08

<0.001

  such as diclofenac or ibuprofen,      
  taken by patients with rheumatoid      
  arthritis may increase their      
  chance of heart disease      

13

 Having lots of inflammation 0.53,0.08 0.84,0.06

0.002

  (‘flares’) of rheumatoid arthritis      
  adds to the increased chance of      
  heart disease      
         
*Estimated Marginal Means and Standard Errors

 


Disclosure: M. Jolly, Pfizer Inc, 9; E. Steinig, None; L. Walt, None; R. Kazkauskaite, None.

To cite this abstract in AMA style:

Jolly M, Steinig E, Walt L, Kazkauskaite R. Web-Based PILOT Intervention Study to Improve Cardiovascular Risk Knowledge Among Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/web-based-pilot-intervention-study-to-improve-cardiovascular-risk-knowledge-among-rheumatoid-arthritis-patients/. Accessed .
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