0911: Peer Coach Intervention to Improve Primary Cardiovascular Disease Screening for Patients with Rheumatoid Arthritis

Iris Navarro-Millan¹, Mackenzie Brown², Yuliana Domínguez Páez³, Geyanne Lui⁴, Joan Weiner¹, Shelley fritz¹, Tien Sydnor-Campbell⁵, Aberdeen Allen⁶, Assem Jabri¹, Shilpa Venkatachalam⁷, Kelly Gavigan⁸, William Benjamin Nowell⁹, Jeffrey Curtis¹⁰, Liana Fraenkel¹¹ and Monika Safford¹, ¹Weill Cornell Medicine, New York, NY, ²Weill Cornell Medicine, Brooklyn, NY, ³Weill Cornell Medicine, Bronx, NY, ⁴Albert Einstein College of Medicine, New York, NY, ⁵Weill Cornell Medicine, Philedelphia, ⁶Weill Cornell Medicine, Parlin, ⁷Global Healthy Living Foundation, New York, NY, ⁸Global Healthy Living Foundation, Upper Nyack, NY, ⁹Global Healthy Living Foundation, Nyack, NY, ¹⁰University of Alabama at Birmingham, Hoover, AL, ¹¹Berkshire Medical Center, Lenox, MA

Background/Purpose: Only 37% of patients with rheumatoid arthritis (RA) receive screening for cardiovascular disease (CVD) despite their high risk. To improve CVD prevention, we designed the CArdiovascular Risk assEssment for patients with Rheumatoid Arthritis (CARE RA) intervention. It consists of patient education alongside the assistance of a peer coach. A peer coach is a person with RA that has been trained to coach another person with RA to request a CVD risk assessment from their rheumatologist. The goal of this abstract is to present the preliminary results for this intervention.

Methods: This is a randomized controlled trial for patients with RA. We included patients with RA between 40-75 years of age, no history of CVD, and no cholesterol test or CVD risk assessment in the past 2 years. We excluded people with diabetes or already on lipid lowering therapy (LLT). Participants were randomized to either CARE RA or a control group. CARE RA participants completed 4 weekly calls with a peer coach right before their rheumatologist appointment, to coach their client on requesting CVD risk from their rheumatologist, and one call the week after their appointment to discuss steps to follow once the intervention was completed. The calls followed a curriculum on RA and CVD, that included strategies to lower the risk for CVD and the importance of a CVD risk assessment. The control arm completed the same curriculum but without the assistance of a peer coach. The primary outcome was the number of participants who received a CVD risk assessment defined as, having a cholesterol test, discussing the results of a cholesterol test with their rheumatologist, or initiating LLT if indicated. Data was collected at baseline (5 weeks prior to the rheumatologist appointment), 1-week, and 3-months after the appointment. Differences between arms were determined at 1-week and 3-months after the rheumatologist appointment.

Results: There were 60 participants (Figure 1); 4 dropped out from CARE RA and 4 from the control arm; mean age was 57, 90% females, 80% white (Table 1). At 1-week, 22 participants in CARE RA versus 18 in the control arm received a CVD risk assessment. At 3-month, all participants that completed CARE RA had a CVD risk assessment (Figure 2; p=0.62) and 5 initiated LLT. No participant in the control arm initiated LLT.

Conclusion: The CARE RA intervention seems feasible by means of participants completing the intervention with the peer coaches. Preliminarily, CARE RA seems promote CVD risk assessment, but a larger sample is needed to obtain definitive results about its effectiveness.
Figure 1. Flow diagram of the patients screened and recruited in the pilot of the CARE RA intervention

Table 1. Baseline Demographics for Participants Enrolled in the CARE RA Program

Figure 2. Number of Participants with Cholesterol Test or LLT Initiation at 1-Week and 3-Month After Completion of CARE RA
Disclosures: I. Navarro-Millan, Sweden Orphan Biovitrum (SOBI); M. Brown, None; Y. Domínguez Páez, None; G. Lui, None; J. Weiner, None; S. fritz, None; T. Sydnor-Campbell, None; A. Allen, None; A. Jabri, None; S. Venkatachalam, None; K. Gavigan, None; W. Nowell, Global Healthy Living Foundation, AbbVie Inc., Amgen, Eli Lilly; J. Curtis, AbbVie/Abbott, Amgen, ArthritisPower, Aqtual, Bendcare, Bristol-Myers Squibb(BMS), CorEvitas, FASTER, GlaxoSmithKlein(GSK), IlluminationHealth, Janssen, Labcorp, Eli Lilly, Myriad, Novartis, Pfizer, Sanofi, Scipher, Setpoint, UCB, United Rheumatology; L. Fraenkel, None; M. Safford, None.