Table 2 Themes and Key Points That Emerged from Focus Groups with Patients with Inflammatory Arthritis (IA) about Cardiovascular Disease (CVD)
Themes | Social Cognitive Theory Construct | Key Points |
|---|---|---|
Barrier Themes | ||
Theme 1:Need for more information about arthritis, prognosis, and IA medications prior to discussing additional topics like CVD risk | Socio-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) risk | Socio-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 medications | Self-efficacy | Participants 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 risk | Social Support Outcome expectation | Participants 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 risk | Peer/Social Support | Participants 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-efficacy | o 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 | |