Ögmundsdottir Michelsen Halldora, Bäck Maria, Ekström Mattias, Hadziosmanovic Nermin, Hagstrom Emil, Leosdottir Margret
Department of Clinical Sciences, Lund University, Malmö, Sweden
Emergency, Geriatrics, Rehabilitation Service, Landspitali Haskolasjukrahus, Reykjavik, Iceland.
BMJ Open. 2025 Jan 7;15(1):e087881. doi: 10.1136/bmjopen-2024-087881.
The objective of this study was to assess the completeness of registration of secondary preventive variables comparing on-site visits with telephone consultations during follow-up after myocardial infarction.
This was an observational study based on the Swedish quality registry SWEDEHEART.
We analysed the proportion of missing values for major secondary preventive target data registered at the 2-month and 1-year follow-up visits, during 2006-2022 (n=101 199). χ tests were used to compare differences in data registration comparing on-site visits with telephone consultations. Patient characteristics and time trends in the proportion of missing values were also analysed.
Baseline characteristics for patients with on-site visits and telephone consultations were similar. At the 2-month follow-up, the proportion of missing data registered at on-site visits compared with telephone consultations was systolic blood pressure 2.4% (n=1729) vs 28.0% (n=5462), low-density lipoprotein cholesterol 9.1% (n=6525) vs 32.6% (n=6360), weight 20.1% (n=14 343) vs 43.0% (n=8401) and haemoglobin A1c for patients with diabetes mellitus 39.4% (n=4594) vs 69.4% (n=2225), p for all <0.0001. The differences were similar at the 1-year follow-up. Self-reported measures such as smoking status, level of physical activity and current medication had a low proportion of missing data (≤2.1%) for both follow-up modalities.
Registration of secondary preventive variables was less complete at telephone consultations compared with on-site cardiac rehabilitation follow-up visits, which might indicate lower quality of care during telephone follow-up. Further analysis on the possible impact of lack of registration of secondary preventive variables on patient outcomes is warranted.
本研究的目的是评估心肌梗死后随访期间，对比现场访视与电话咨询时二级预防变量的登记完整性。
这是一项基于瑞典质量登记系统SWEDEHEART的观察性研究。
我们分析了2006年至2022年期间（n=101199），在2个月和1年随访访视时登记的主要二级预防目标数据的缺失值比例。使用χ检验来比较现场访视与电话咨询在数据登记方面的差异。还分析了患者特征以及缺失值比例的时间趋势。
现场访视患者与电话咨询患者的基线特征相似。在2个月随访时，现场访视登记的缺失数据比例与电话咨询相比，收缩压为2.4%（n=1729）对28.0%（n=5462），低密度脂蛋白胆固醇为9.1%（n=6525）对32.6%（n=6360），体重为20. .1%（n=14343）对43.0%（n=8401），糖尿病患者的糖化血红蛋白为39.4%（n=4594）对69.4%（n=2225），所有p值均<0.0001。1年随访时差异相似。自我报告的指标，如吸烟状况、身体活动水平和当前用药情况，两种随访方式的缺失数据比例均较低（≤2.1%）。
与现场心脏康复随访访视相比，电话咨询时二级预防变量的登记较不完整，这可能表明电话随访期间的护理质量较低。有必要进一步分析二级预防变量登记缺失对患者结局的可能影响。
