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Screening of Hyperlipidemia Among Patients With Rheumatoid Arthritis in the United States
Author(s) -
NavarroMillán Iris,
Yang Shuo,
Chen Lang,
Yun Huifeng,
Jagpal Aprajita,
Bartels Christie M.,
Fraenkel Liana,
Safford Monika M.,
Curtis Jeffrey R.
Publication year - 2019
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23810
Subject(s) - medicine , rheumatoid arthritis , hyperlipidemia , confidence interval , hazard ratio , diabetes mellitus , population , rheumatology , specialty , physical therapy , family medicine , endocrinology , environmental health
Objective To determine the proportion of primary lipid screening among patients with rheumatoid arthritis (RA) and compare it with those among patients with diabetes mellitus (DM) and patients with neither RA nor DM, and to assess whether primary lipid screening varied according to the health care provider (rheumatologist versus non‐rheumatologist). Methods We analyzed claims data from US private and public health plans from 2006–2010. Eligibility requirements included continuous medical and pharmacy coverage for ≥12 months (baseline period) and > 2 physician diagnoses and relevant medications to define RA, DM, RA and DM, or neither condition. Among the 330,695 eligible participants, we calculated the proportion with a lipid profile ordered during the 2 years following baseline. Time‐varying Cox proportional hazard models were used to determine the probability of hyperlipidemia screening in participants with RA according to provider specialty. Results More than half of the patients were ages 41–71 years. Among patients with RA (n = 12,182), DM (n = 62,834), RA and DM (n = 1,082), and those who did not have either condition (n = 167,811), the proportion screened for hyperlipidemia was 37%, 60%, 55%, and 41%, respectively. Patients with RA who visited a rheumatologist and a non‐rheumatology clinician during follow‐up had a 55% (95% confidence interval 1.36–1.78) higher screening probability than those who only visited a rheumatologist. Conclusion Primary lipid screening was suboptimal among patients with RA. It was also lower for patients with DM and minimally different from the general population. Screening was higher for RA patients who received care from both a rheumatologist and a non‐rheumatologist (e.g., primary care physician).