Improving the Care of Patients With Rheumatic Diseases Who Have Cardiovascular Risk: Comment on the Article by Gossec et al


We compliment Gossec and colleagues for their strong article published recently in Arthritis Care & Research (1). The authors addressed important and necessary practical aspects of performing cardiovascular disease (CVD) risk assessments for patients with rheumatic diseases and rendering appropriately robust documentation.

Indeed, from our experience, we can appreciate the necessity to perform better CVD risk asessments. At our institution (which is a public/county medical center and major teaching hospital serving a primarily poor, neglected, immigrant, uninsured, and often transient urban population) ([2]), we noted only 3 instances of any documentation of addressing and/or managing CVD risk from 152 electronic charts of patients with rheumatoid arthritis and systemic lupus erythematosus in our rheumatology and primary care clinics ([3]).

Gossec et al have shown ([1]) that it is a challenge to always do the right thing in the right way at the right time for the right patient in order to truly provide quality care (restating Eisenberg's definition) ([4]). As has been presented imaginatively and articulately by Fitzgerald ([5]), appropriate, precise documentation is essential. It is only by translating what we know to be clinically valuable to routine practice, as Gossec and collaborators have demonstrated ([1]), that we will achieve providing the care now expected of us by society, care that is safe, effective, patient centered, timely, efficient, and equitable (as articulated by the Institute of Medicine) ([6]). Our own plans to improve the quality of our performance will draw upon the experience of Gossec et al ([1]).