Thank you Kathryn. This is a great article and raises important questions. I've been experimenting with how to engage primary care physicians on this issue and have found an effective method: I ensure that each patient has a fasting lipid profile (all results are copied to the PCP as a rule) and as soon as the lipid profile result appears in my inbox, I open the patient file and send a proforma letter to the PCP, stating:
"Please find a copy of (patient)'s fasting lipid profile below. Whilst this forms part of the standard cardiovascular risk calculation, (patient)'s rheumatic disease does not. When calculating (patient)'s cardiovascular risk, please consider adding a risk multiplier of 1.5/2.0/2.5 for (rheumatic disease)."
A brief summary of the evidence base is included below this, referencing Conrad et al. Ann Rheum Dis 2022; Published Online First: 28 November 2022. doi: 10.1136/ard-2022-223315.
Sending this letter requires little effort. I have found that in more cases than not, this results in a change of management on the part of the PCP.
I hope that my experience helps others negotiate this issue without adding unduly to the burden of care.
Thank you Kathryn. This is a great article and raises important questions. I've been experimenting with how to engage primary care physicians on this issue and have found an effective method: I ensure that each patient has a fasting lipid profile (all results are copied to the PCP as a rule) and as soon as the lipid profile result appears in my inbox, I open the patient file and send a proforma letter to the PCP, stating:
"Please find a copy of (patient)'s fasting lipid profile below. Whilst this forms part of the standard cardiovascular risk calculation, (patient)'s rheumatic disease does not. When calculating (patient)'s cardiovascular risk, please consider adding a risk multiplier of 1.5/2.0/2.5 for (rheumatic disease)."
A brief summary of the evidence base is included below this, referencing Conrad et al. Ann Rheum Dis 2022; Published Online First: 28 November 2022. doi: 10.1136/ard-2022-223315.
Sending this letter requires little effort. I have found that in more cases than not, this results in a change of management on the part of the PCP.
I hope that my experience helps others negotiate this issue without adding unduly to the burden of care.