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Table 2 Themes and Key Points That Emerged from Focus Groups with Patients with Inflammatory Arthritis (IA) about Cardiovascular Disease (CVD)

From: Barriers and facilitators for screening and treatment of hyperlipidemia among patients with inflammatory arthritis

ThemesSocial Cognitive Theory ConstructKey Points
Barrier Themes
Theme 1:Need for more information about arthritis, prognosis, and IA medications prior to discussing additional topics like CVD riskSocio-cultural Factors (Limited resources to learn about IA and limited knowledge about IA itself)Participants were interested in understanding the following:
o The expectations for living with arthritis
o Side effects of arthritis medication and possible interaction with other medications
o Risks and benefits of being on medications for arthritis
o Interest in learning about healthy behaviors that they can do to avoid an arthritis flare (ex. exercise or avoid certain types of food)
Theme 2: Lack of knowledge about how IA increases cardiovascular disease (CVD) riskSocio-cultural Factors (Limited knowledge about the relationship between IA and CVD)Participants were interested in learning about the following:
o How arthritis affects the heart
o How they can decrease CVD risk (exercise, diet, stress reduction, and medications)
o Side effects of lipid lowering medication and interactions with other medications
o Learning about their increased CVD risk associated with IA resulted in some participants feeling motivated to request a cholesterol test
Theme 3:Lifestyle changes to reduce overall CVD risk rather than medicationsSelf-efficacyParticipants were interested in the following:
o Integrating CVD risk reduction program within the overall arthritis management program, and not addressing CVD as a separate issue
o Learning about engaging in lifestyle changes to control cholesterol before considering initiation of a statin
Theme 4:Improving doctor-patient communication about IA, medications, and CVD riskSocial Support Outcome expectationParticipants considered their treating physician/rheumatologist as the most reliable source of information about arthritis and expressed interest in identifying the following unknowns:
o Discussing topics with their rheumatologist regarding their CVD risk in the setting of having IA
o Questions they should ask about arthritis and CVD risk
o The appropriate frequency of communication and visits with the rheumatologist
o Better ways to engage their rheumatologist in addressing their concerns about medications, laboratory results, and symptoms
Facilitator Theme
Theme 5:Potential for peer coaches (trained patients with IA) to help overcome barriers to screening and treatment of hyperlipidemia to lower CVD riskPeer/Social SupportParticipants expressed interest in discussing the following topics with a peer coach (trained patient with IA):
o How the peer coach managed having arthritis
o Feelings about taking medications for arthritis
o Benefits and issues that they have had with IA medications
o Whether the peer coach has experienced a CVD event
o What are they (peer coaches) doing to reduce their CVD risk
Peer/Social Support Self-efficacyo Best exercise program (weights, cardio, pool exercises) and location of related resources available in their local area
o Having another patient with arthritis to engage with them in a workout program (workout partner)
o Assistance in better communication with their doctor for adequate CVD screening and treatment