POS1484-HPR PATIENTS’ PERSPECTIVES ON ADHERENCE TO CARDIOVASCULAR SCREENING CONSULTATION AND LIFESTYLE CHANGES
Authors: J. K. Karstensen, A. Bremander, K. Engholm Nielsen, J. Primdahl, J. Reffstrup Christensen
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The European Alliance of Associations for Rheumatology (EULAR) and national guidelines recommend systematic cardiovascular (CV) risk assessment and management of patients with rheumatoid arthritis (RA). In addition, adherence to a healthy lifestyle is recommended [1]. As a result, all patients with RA at the Danish Hospital for Rheumatic Diseases (DHR) are invited to attend a CV screening consultation. During the screening consultation, an outpatient nurse assesses the patient's overall risk profile and discusses the patient's motivation for potential lifestyle changes. Based on the risk score, the patients are invited for a follow-up screening consultation in 1-3 years. <h3>Objectives:</h3> I) To explore the patients' perspectives on participation and adherence to CV screening and II) to explore the patients' perspectives on lifestyle changes. <h3>Methods:</h3> A qualitative explorative design was applied. Patients with RA who had participated in at least one CV screening consultation at DHR in the period 2019-2021 were invited to participate. An interview guide was developed and reviewed by two patient research partners. Individual semi-structured interviews were conducted from February-June 2022. Data were analysed using qualitative content analysis as described by Graneheim and Lundman [2]. <h3>Results:</h3> Nine women and seven men with RA (aged 47-76) participated. The analysis derived two themes, each with two subthemes (Figure 1). The first theme, <i>accepting an offer</i>, encompasses the participants' positive experiences from participation and their motivation for to attend the screening consultation. The sub-themes were: <i>1a: Engagement in the screening consultation:</i> Motivation for participation differed among the participants, ranging from simply accepting the invitation to join as a proactive precaution to reduce the participant's own CV risk. <i>1b: Risk awareness:</i> A heightened risk awareness proved pivotal, motivating participants to not only accept the initial invitation but also diligently adhere to the subsequent follow-up CV screening consultations. The second theme, <i>living with a chronic disease and embracing changes</i>, encompasses the participants' views on lifestyle changes. The two sub-themes were: <i>2a: Motivation for lifestyle changes:</i> During the screening process, participants discussed and received lifestyle recommendations and guidance from the nurses. While some embraced these recommendations and made changes in their lifestyle, others did not implement changes despite being aware of their health risks. <i>2b: Strategies to achieve lifestyle changes:</i> A supportive social network played a crucial role for potential lifestyle changes, providing motivation and accountability, particularly in engaging in physical activity with others. <h3>Conclusion:</h3> The participants' motivation for participation in CV screening varied, spanning from just accepting an invitation to participate to reduce their CV risk. The overall perception of the screening consultations was positive. While not immediately leading to significant lifestyle changes for all, the consultations led to enhanced awareness of CV risk and the importance of a healthy lifestyle. The participants' social network played a crucial role for potential lifestyle changes. This highlights the crucial role of personal motivation in influencing health behaviours and underscores the need for comprehensive support for patients with RA to achieve lifestyle changes. Overall, supporting patients with RA should encompass both raising awareness of CV risks and providing individualised support to make desired lifestyle changes. <h3>REFERENCES:</h3> [1] Agca et al. 2017, PMID: 27697765. [2] Graneheim and Lundman. 2004, PMID: 14769454. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>