Completion of registration of risk factor variables during telephone vs on-site follow-up after myocardial infarction: a nationwide observational study in 101 199 patients from contemporary clinical practice in Sweden.

Abstract

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). χ² 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.