CoHeart, 2001 - 2006

The aim of the study was to assess the effectiveness of secondary preventive care of ischaemic heart disease amongst a cohort of patients with existing ischaemic heart disease identified in a cross-sectional study in 2000/1 in a randomly selected, representative, stratified sample of 37 general practices in the West of Ireland. This project was funded by a three-year Health Research Board project grant. Number of patients: 1,609 Inclusion criteria: Previous AMI, PTCA, CABG or diagnosis of anginaKey variables Primary outcomes include: All-cause or IHD-related death Secondary outcomes include: AMI, PTCA and/or CABG since baseline. Health status measured using the SF36 questionnaire at baseline and SF12 at follow-up. Age (in years), sex, rurality (whether the practice was in a rural or urban area), deprivation (GMS status). Coexisting diabetes (type I or II) and chronic kidney disease (serum creatinine level). Prescription of beta-blockers, angiotensin-converting enzyme (ACE) inhibitors or statins. Measure of the process of care: number primary care visits; number of hospital visits. Blood pressure, total cholesterol, body Mass Index, Exercise (Godin Leisure-Time Exercise Questionnaire); Smoking status; Diet (DINE, including question regarding portions of fresh fruit and vegetables). Data collection Baseline A total of 1,609 eligible patients were identified for inclusion, 3.16% (95% CI 2.86-3.62) of the total practice population. Postal Questionnaire Thirty four patients were excluded from receiving the questionnaire at the request of their GP. Of the 1,577 sent, 1,084 (68.7%) were returned. Follow up All the practices that participated at baseline did so at follow up. Of the 37 practices, 9 (24.3%) used electronic patient records only, 20 (54.1%) used a combination of electronic and paper charts and 8 (21.6%) used paper charts only. Charts were located and searched for 1592/1609 patients (98.9%). Patient questionnaires were sent to 1269 patients; 340 patients were excluded from receipt of questionnaires by their general practitioners for reasons of death since baseline, serious illness, moving away, illiteracy or difficult family circumstances. Questionnaires were returned by 876 (69%). Missing data Information bias is possible where measurements are out of the control of a study and open to variation in measurement methods and accuracy from clinician to clinician as well as recording errors and omission. Datasets were not complete for every patient at either baseline or follow up. Data were most complete for major outcomes and clinical process of care variables, least complete for lifestyle related data and patient-reported diet data. Reliable verification data on cause of death were available for 90.7% of deceased cohort members