title: 'All singing from the same hymn sheet': healthcare professionals' perceptions of developing patient education material about the cardiovascular aspects of rheumatoid arthritis.
abstract: OBJECTIVE
  Cardiovascular disease (CVD) is the leading cause of death in Britain, and its prevention is a priority. Rheumatoid arthritis (RA) patients have an increased risk of CVD, and management of modifiable classical risk factors requires a programme with patient education at its heart. Before a programme for RA patients is implemented, it is important to explore the perceptions of patients and relevant healthcare professionals and consider how these could influence the subsequent content, timing and delivery of such education. Here, we assess healthcare professionals' perceptions.
  
  
  METHODS
  Qualitative focus group methodology was adopted. Four group meetings of healthcare professionals were held using a semi-structured interview schedule. The focus group transcripts were analysed using interpretative phenomenological analysis.
  
  
  RESULTS
  Three superordinate themes emerged: professional determinations about people with RA, including their perceptions about patients' priorities and motivations; communication about CVD risk, including what should be communicated, how, to whom and when; and responsibility for CVD management, referring to patients and the healthcare community.
  
  
  CONCLUSIONS
  Although healthcare professionals agree that it is important to convey the increased CVD risk to patients with RA, there is concern they may be less proactive in promoting risk management strategies. There was uncertainty about the best time to discuss CVD with RA patients. Maintaining a close relationship between primary and secondary care was thought to be important, with all healthcare professionals 'singing from the same hymn sheet'. These findings can inform the development of novel education material to fulfil a currently unmet clinical need.
authors.affiliation: Department of Rheumatology, Dudley Group of Hospitals NHS Foundation Trust, Russells Hall Hospital, Dudley, UK. hollypiper@hotmail.com
authors.forename: Holly
authors.initials: H
authors.lastname: John
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Hale
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Treharne
authors.forename: Douglas
authors.initials: D
authors.lastname: Carroll
authors.forename: George D
authors.initials: GD
authors.lastname: Kitas
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians / Q000523:psychology; D010353:Patient Education as Topic; D010465:Perception; D010820:Physicians / Q000523:psychology; D016730:Program Development; D012306:Risk