Key result
Non-participants in a CHD survey had significantly higher odds of depression (OR 14.5; 95% CI 4.4-121.5) and higher Charlson comorbidity index (OR 3.4; 95% CI 2.8-4.3) compared to participants.
Why the study?
Non-participants in clinical studies of CHD patients may differ in characteristics and coronary risk factors from participants, potentially biasing prevention study results.
Do patient characteristics and coronary risk factors differ between participants and non-participants in a survey of CHD patients?
Cross-Sectional (n=1,356)
Do patient characteristics and coronary risk factors differ between participants and non-participants in a survey of CHD patients?
Non-participants in CHD prevention studies have a higher prevalence of coronary risk factors and comorbidities, suggesting that risk factor control may be overestimated in clinical studies.
Non-participants had higher comorbidity and depression; leaves open whether prevention studies overestimate risk factor control in CHD.
OBJECTIVES: We aim to compare patient characteristics and coronary risk factors among participants and non-participants in a survey of CHD patients. METHODS: A cross-sectional study explored characteristics and risk factors in patients hospitalized for acute myocardial infarction and/or revascularization. Study data collected from hospital medical records were compared between participants (n = 1127, 83%) and non-participants (n = 229, 16%), who did not consent to participation in the clinical study. RESULTS: Non-participants showed statistically higher prevalence of women (28% versus 21%), ethnic minorities (6% versus 3%), patients living alone (26% versus 19%), depression (19% versus 6%), anxiety (9% versus 3%), hypertension (54% versus 43%) and diabetes (24% versus 17%). Significantly higher multi-adjusted odds ratios were found for Charlson comorbidity index 3.4 (95% confidence interval (CI), 2.8, 4.3) and depression 14.5 (4.4, 121.5) in non-participants. CONCLUSIONS: Non-participants do have higher prevalence of important coronary risk factors compared to participants, and risk factor control may thus be overestimated in available prevention studies. Patients with somatic comorbidity and depression appear to be at particular risk of non-participation in the present study. New strategies accounting for the causes of nonadherence are important to improve secondary prevention in CHD.
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Munkhaugen et al. (2016) conducted a cross-sectional in Coronary heart disease (acute myocardial infarction and/or revascularization) (n=1,356). Non-participation in clinical study vs. Participation in clinical study was evaluated on Depression (OR 14.5, 95% CI 4.4-121.5). Non-participants in a CHD survey had significantly higher odds of depression (OR 14.5; 95% CI 4.4-121.5) and higher Charlson comorbidity index (OR 3.4; 95% CI 2.8-4.3) compared to participants.
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