Albers, Maarit (2023) Optimaliseren van de RE-SAMPLE inclusie: ontbrekende gegevens in het EPD. thesis, Medicine.
Full text available on request.Abstract
Introduction: The disease state of COPD patients evolves over time. However, the electronic health record (EHR) does not automatically update. This can cause a discrepancy between the current health status and the information in the EHR, which could lead to suboptimal treatment. Aims: To examine the extent to which data on spirometry, anxiety and depression, and comorbidities in the EHR reflect the current health status. Methods: The population consisted of patients with COPD and comorbidities under treatment in secondary care being enrolled in the RE-SAMPLE cohort study or the COPE III study. Measurements from the study baseline visit were compared with data in the EHR using the McNemar test and Cohen's kappa. Results: We found a statistically significant difference between the GOLD stage listed in the EHR and measured at baseline. According to the EHR and baseline spirometry respectively, 46.7% and 57.1% had GOLD stage II, 43.5% and 37.7% stage III, and 10.4% and 5.2% stage IV of all patients (n=154) (weighted kappa 0.65; p < 0.001). There was also a statistically significant difference between reported anxiety and depression in the EHR and anxiety and depression symptoms measured by the HADS score at baseline (p < 0.001). Of all patients (n=196), 11.2% suffered from anxiety and/or depression according to the EHR and 49.5% according to the HADS score (kappa -0.104; p = 0.021). In terms of comorbidities, hypertension was the most common comorbidity in the studied patients with COPD. 33.5% of the patients had hypertension, followed by the comorbidities atrial fibrillation (17.2%), obstructive sleep apnea (15.4%) and peripheral arterial vascular disease (14.2%). Conclusions: There was a statistically significant difference in GOLD stage and anxiety or depression between the EHR and the current health status. Anxiety and depression were mostly underdiagnosed in the EHR. This problem could be solved by more regular screening for symptoms of anxiety and depression.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | van der Palen, prof.dr. J.A.M. and Bucsán, C.C. |
| Faculty: | Medical Sciences |
| Date Deposited: | 18 Apr 2023 12:58 |
| Last Modified: | 18 Apr 2023 12:58 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3477 |
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