Patient Perception Versus Medical Record Entry of Health-Related Conditions Among Patients With Heart Failure

• Type of Material: Article
• Authors: Adnan S. Malik, Emory University; Grigorios Giamouzis, Larissa University; Vasiliki (Vicki) Georgiopoulou, Emory University; Lucy V. Fike, Emory University; Andreas Kalogeropoulos, Emory University; Catherine R. Norton, Emory University; Dan Sorescu, Emory University; Sidra Azim, Emory University; Sonjoy Laskar, Emory University; Andrew L Smith, Emory University; Sandra B Dunbar, Emory University; Javed Butler, Emory University
• Language: English
• Date: 2011-02-15
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2011 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.1016/j.amjcard.2010.10.017
• Title of Journal or Parent Work: American Journal of Cardiology
• ISSN: 0002-9149
• Volume: 107
• Issue: 4
• Start Page: 569
• End Page: 572
• Grant/Funding Information: This project was funded by the Emory University Heart and Vascular Board grant titled “The Atlanta Cardiomyopathy Consortium,” and supported in part by PHS grant (UL1 RR025008, KL2 RR025009 or TL1 RR025010) from the Clinical and Translational Science Award program, National Institutes of Health, National Center for Research Resources.
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

A shared understanding of medical conditions between patients and their health care providers may improve self-care and outcomes. In this study, the concordance between responses to a medical history self-report (MHSR) form and the corresponding provider documentation in electronic health records (EHRs) of 19 select co-morbidities and habits in 230 patients with heart failure were evaluated. Overall concordance was assessed using the κ statistic, and crude, positive, and negative agreement were determined for each condition. Concordance between MHSR and EHR varied widely for cardiovascular conditions (κ = 0.37 to 0.96), noncardiovascular conditions (κ = 0.06 to 1.00), and habits (κ = 0.26 to 0.69). Less than 80% crude agreement was seen for history of arrhythmias (72%), dyslipidemia (74%), and hypertension (79%) among cardiovascular conditions and lung disease (70%) and peripheral arterial disease (78%) for noncardiovascular conditions. Perfect agreement was observed for only 1 of the 19 conditions (human immunodeficiency virus status). Negative agreement >80% was more frequent than >80% positive agreement for a condition (15 of 19 [79%] vs 8 of 19 [42%], respectively, p = 0.02). Only 20% of patients had concordant MSHRs and EHRs for all 7 cardiovascular conditions; in 40% of patients, concordance was observed for ≤5 conditions. For noncardiovascular conditions, only 28% of MSHR-EHR pairs agreed for all 9 conditions; 37% agreed for ≤7 conditions. Cumulatively, 39% of the pairs matched for ≤15 of 19 conditions. In conclusion, there is significant variation in the perceptions of patients with heart failure compared to providers’ records of co-morbidities and habits. The root causes of this variation and its impact on outcomes need further study.