Exploring cardiovascular risk management implementation in Dutch rheumatoid arthritis patients: insights from rheumatologists and patients

Abstract Objectives To explore the implementation of cardiovascular risk management (CVRM) in Dutch rheumatoid arthritis (RA) patients from the perspective of rheumatologists and patients. Methods An online survey was conducted among Dutch rheumatologists, rheumatology physician assistants (PAs), and RA patients. Healthcare providers completed a 37-item adapted version of the Determinants of Implementation Behavior Questionnaire (DIBQ) to assess various aspects of CVRM implementation behavior on a 7-point Likert scale. Simultaneously, a 13-item questionnaire was administered to RA patients to gather experiences related to CVRM. Data for both surveys were collected online between September 23 and December 1, 2024. Results A total of 85 healthcare providers (93% rheumatologists, mean age 47.2 ± 8.8, 72% female) and 145 RA patients (mean age 58 ± 12.6 years; 89% female) completed the survey. Providers did not seem to lack (self-reported) knowledge on CVRM. Yet, significant implementation challenges were identified across several domains, including skills, professional roles, and beliefs about capabilities. Time constraints, limited resources, insufficient financial support, and the absence of local protocols were cited as major barriers. From the patient perspective, only 39% reported being informed about RA-related cardiovascular risks, mostly by rheumatologists. Rheumatologists frequently provided guidance on physical activity (21%), while general practitioners were more active in managing traditional cardiovascular risk factors, prescribing medications (23%), and offering self-management advice (16%). Conclusion Our study highlights the main challenges in implementing CVRM in daily practice, indicating the need for the development of targeted strategies to overcome these barriers.