Systemic lupus erythematosus and cardiac risk factors: medical record documentation and patient adherence
Systemic lupus erythematosus and cardiac risk factors: medical record documentation and patient adherence
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DOI：
10.1177/0961203311403639
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发表时间：
2011-10-01
期刊：
影响因子：
2.6
通讯作者：
Nived, O.
中科院分区：
文献类型：
--
作者：
Bengtsson, C.;Bengtsson, A. A.;Nived, O.
这项研究探索患者对心脏危险因素(CRF)的知识，分析如何在临床实践中记录关于CRF的信息和建议，并评估患者对减少CRF的指示的遵守情况。符合>；=4 ACR标准的系统性红斑狼疮(SLE)患者通过填写有效的心血管健康问卷(CHQ)参与研究。Kappa统计用于将医疗记录与自我报告的CHQ(协议)进行比较，并评估依从性。在已知的系统性红斑狼疮患者中，有211人(72%)参与了研究。患者的平均年龄为55岁。超过70%的SLE患者认为高血压、肥胖、吸烟和高胆固醇血症是非常重要的CRF。病历记录和患者报告之间的一致性在高血压、超重和高胆固醇血症(kappa 0.42-0.60)方面中等，但在糖尿病方面(kappa 0.66)很高。患者自我报告遵守他们收到的关于药物治疗的建议的程度相当高，可以说是完美的(kappa 0.65-1.0)。对于高血压和超重患者的生活方式改变，依从性仅为中等到中等(kappa 0.13-0.47)。在这项研究中，瑞典SLE患者对传统CRF的认识良好。然而，患者的自我报告和CRF档案的病历记录之间的一致性，以及患者对CRF档案的医疗建议的遵从性，都可以得到改善。狼疮(2011)20,1057-1062。
This study explores patients' knowledge of cardiac risk factors (CRFs), analyses how information and advice about CRFs are documented in clinical practice, and assesses patient adherence to received instructions to decrease CRFs. Systemic lupus erythematosus (SLE) patients with >= 4 ACR criteria participated through completing a validated cardiovascular health questionnaire (CHQ). Kappa statistics were used to compare medical records with the self-reported CHQ (agreement) and to evaluate adherence. Two hundred and eleven (72%) of the known patients with SLE participated. The mean age of the patients was 55 years. More than 70% of the SLE patients considered hypertension, obesity, smoking and hypercholesterolaemia to be very important CRFs. The agreement between medical record documentation and patients' reports was moderate for hypertension, overweight and hypercholesterolaemia (kappa 0.42-0.60) but substantial for diabetes (kappa 0.66). Patients' self-reported adherence to advice they had received regarding medication was substantial to perfect (kappa 0.65-1.0). For lifestyle changes in patients with hypertension and overweight, adherence was only fair to moderate (kappa 0.13-0.47). Swedish SLE patients' awareness of traditional CRFs was good in this study. However, the agreement between patients' self-reports and medical record documentation of CRF profiles, and patients' adherence to medical advice to CRF profiles, could be improved. Lupus (2011) 20, 1057-1062.