A Retrospective Cohort Study on Lifestyle Habits of Cardiovascular Patients: How Informative Are Medical Records?

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2009 Apr 3

PMID 19338656

Citations 4

Authors

Annemarie J Fouwels

Sebastiaan J H Bredie

Hub Wollersheim

Gerard M Schippers

Affiliations

Soon will be listed here.

Abstract

Background: To evaluate the vigilance of medical specialists as to the lifestyle of their cardiovascular outpatients by comparing lifestyle screening as registered in medical records versus a lifestyle questionnaire (LSQ), a study was carried out at the cardiovascular outpatient clinic of the university hospital of Nijmegen, The Netherlands, between June 2004 and June 2005.

Methods: For 209 patients information from medical records on lifestyle habits, physician feedback, and interventions in the past year was compared to data gathered in the last month by a self-report LSQ.

Results: Doctors register smoking habits most consistently (90.4%), followed by alcohol use (81.8%), physical activity (50.2%), and eating habits (27.3%). Compared to the LSQ, smoking, unhealthy alcohol use, physical activity, and unhealthy eating habits are underreported in medical records by 31, 83, 54 and 97%, respectively. Feedback, advice or referral was documented in 8% for smoking, 3% for alcohol use, 12% for physical activity, and 26% for eating habits.

Conclusion: Lifestyle is insufficiently registered or recognized by doctors providing routine care in a cardiovascular outpatient setting. Of the unhealthy lifestyle habits that are registered, few are accompanied by notes on advice or intervention. A lifestyle questionnaire facilitates screening and interventions in target patients and should therefore be incorporated in the cardiovascular setting as a routine patient intake procedure.

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References

Jensen G, Nyboe J, Appleyard M, Schnohr P . Risk factors for acute myocardial infarction in Copenhagen, II: Smoking, alcohol intake, physical activity, obesity, oral contraception, diabetes, lipids, and blood pressure. Eur Heart J. 1991; 12(3):298-308. DOI: 10.1093/oxfordjournals.eurheartj.a059894. View

Bush K, Kivlahan D, McDonell M, Fihn S, Bradley K . The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998; 158(16):1789-95. DOI: 10.1001/archinte.158.16.1789. View

Appel L, Champagne C, Harsha D, Cooper L, Obarzanek E, Elmer P . Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA. 2003; 289(16):2083-93. DOI: 10.1001/jama.289.16.2083. View

Rethans J, Martin E, Metsemakers J . To what extent do clinical notes by general practitioners reflect actual medical performance? A study using simulated patients. Br J Gen Pract. 1994; 44(381):153-6. PMC: 1238838. View

Murray R, Coleman T, Antoniak M, Fergus A, Britton J, Lewis S . The potential to improve ascertainment and intervention to reduce smoking in primary care: a cross sectional survey. BMC Health Serv Res. 2008; 8:6. PMC: 2245929. DOI: 10.1186/1472-6963-8-6. View

Mant D, Phillips A . Can the prevalence of disease risk factors be assessed from general practice records?. Br Med J (Clin Res Ed). 1986; 292(6513):102-4. PMC: 1339118. DOI: 10.1136/bmj.292.6513.102. View

Ornish D, Scherwitz L, Billings J, Brown S, Gould K, Merritt T . Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998; 280(23):2001-7. DOI: 10.1001/jama.280.23.2001. View

Jakobsson U, Westergren A . Statistical methods for assessing agreement for ordinal data. Scand J Caring Sci. 2005; 19(4):427-31. DOI: 10.1111/j.1471-6712.2005.00368.x. View

van Drenth B, Hulscher M, Mokkink H, van der Wouden J, van Weel C, Grol R . Cardiovascular risk detection and intervention in general practice: the patients' views. Int J Qual Health Care. 2000; 12(4):319-24. DOI: 10.1093/intqhc/12.4.319. View

10.

Bazzano L, He J, Ogden L, Loria C, Whelton P . Dietary fiber intake and reduced risk of coronary heart disease in US men and women: the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Intern Med. 2003; 163(16):1897-904. DOI: 10.1001/archinte.163.16.1897. View

11.

Saunders J, Aasland O, Babor T, De la Fuente J, Grant M . Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993; 88(6):791-804. DOI: 10.1111/j.1360-0443.1993.tb02093.x. View

12.

Brull R, Ghali W, Quan H . Missed opportunities for prevention in general internal medicine. CMAJ. 1999; 160(8):1137-40. PMC: 1230265. View

13.

Pomerleau C, Carton S, Lutzke M, Flessland K, Pomerleau O . Reliability of the Fagerstrom Tolerance Questionnaire and the Fagerstrom Test for Nicotine Dependence. Addict Behav. 1994; 19(1):33-9. DOI: 10.1016/0306-4603(94)90049-3. View

14.

Bazzano L, He J, Ogden L, Loria C, Vupputuri S, Myers L . Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Am J Clin Nutr. 2002; 76(1):93-9. DOI: 10.1093/ajcn/76.1.93. View

15.

Eccles M, Ford G, Duggan S, Steen N . Are postal questionnaire surveys of reported activity valid? An exploration using general practitioner management of hypertension in older people. Br J Gen Pract. 2000; 49(438):35-8. PMC: 1313315. View

16.

Palonen K, Allison J, Heudebert G, Willett L, Kiefe C, Wall T . Measuring resident physicians' performance of preventive care. Comparing chart review with patient survey. J Gen Intern Med. 2006; 21(3):226-30. PMC: 1828097. DOI: 10.1111/j.1525-1497.2006.00338.x. View

17.

Pinto B, Goldstein M, Marcus B . Activity counseling by primary care physicians. Prev Med. 1998; 27(4):506-13. DOI: 10.1006/pmed.1998.0335. View

18.

Craig C, Marshall A, Sjostrom M, Bauman A, Booth M, Ainsworth B . International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003; 35(8):1381-95. DOI: 10.1249/01.MSS.0000078924.61453.FB. View

19.

van Berkel T, Boersma H, Roos-Hesselink J, Erdman R, Simoons M . Impact of smoking cessation and smoking interventions in patients with coronary heart disease. Eur Heart J. 1999; 20(24):1773-82. DOI: 10.1053/euhj.1999.1658. View

20.

Room R, Babor T, Rehm J . Alcohol and public health. Lancet. 2005; 365(9458):519-30. DOI: 10.1016/S0140-6736(05)17870-2. View