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Abstract：
Patients with rheumatoid arthritis (RA) have an increased risk of developing cardiovascular disease (CVD). Identification of at-risk patients is paramount to initiate preventive care and tailor treatments accordingly. Despite international guidelines recommending all patients with RA undergo CVD risk assessment, rates remain suboptimal. The objectives of this review were to map the strategies used to conduct CVD risk assessments in patients with RA in routine care, determine who delivers CVD risk assessments, and identify what composite measures are used. The Joanna Briggs Institute methodological guidelines were used. A literature search was conducted in electronic and grey literature databases, trial registries, medical clearing houses, and professional rheumatology organisations. Findings were synthesised narratively. A total of 12 studies were included. Strategies reported in this review used various system-based interventions to support delivery of CVD risk assessments in patients with RA, operationalised in different ways, adopting two approaches: (a) multidisciplinary collaboration, and (b) education. Various composite measures were cited in use, with and without adjustment for RA. Results from this review demonstrate that although several strategies to support CVD risk assessments in patients with RA are cited in the literature, there is limited evidence to suggest a standardised model has been applied to routine care. Furthermore, extensive evidence to map how health care professionals conduct CVD risk assessments in practice is lacking. Research needs to be undertaken to establish the extent to which healthcare professionals are CVD risk assessing their patients with RA in routine care. Key Points • A limited number of system-based interventions are in use to support the delivery of CVD risk assessments in patients with RA. • Multidisciplinary team collaboration, and education are used to operationalise interventions to support Health Care Professionals in conducting CVD risk assessments in practice. • The extent to which Health Care Professionals are CVD risk assessing their patients with RA needs to be established.
摘要：
类风湿关节炎（RA）患者患心血管疾病（CVD）的风险增加。识别有风险的患者对于启动预防性护理和相应地定制治疗至关重要。尽管国际指南建议所有RA患者进行CVD风险评估，利率仍然是次优的。本综述的目的是绘制用于在常规护理中对RA患者进行CVD风险评估的策略。确定谁提供CVD风险评估，并确定使用了哪些综合措施。使用了JoannaBriggs研究所的方法指南。在电子和灰色文献数据库中进行了文献检索，审判登记处，医疗结算所,和专业风湿病组织。调查结果是以叙述方式综合的。共纳入12项研究。本综述中报告的策略使用了各种基于系统的干预措施来支持RA患者的CVD风险评估。以不同的方式运作，采用两种方法：(A)多学科合作，（二）教育。在使用中引用了各种综合措施，有和没有RA调整。这篇综述的结果表明，尽管文献中引用了几种支持RA患者CVD风险评估的策略，有有限的证据表明标准化模式已应用于常规护理.此外，缺乏大量证据来绘制卫生保健专业人员如何在实践中进行心血管疾病风险评估。需要进行研究，以确定医疗保健专业人员在常规护理中评估其RA患者的CVD风险程度。关键点•使用数量有限的基于系统的干预措施来支持RA患者的CVD风险评估。•多学科团队协作，和教育用于实施干预措施，以支持医疗保健专业人员在实践中进行CVD风险评估。•需要确定医疗保健专业人员对RA患者的CVD风险评估的程度。
