Provision of professional interpreters and Heart School attendance for foreign-born compared with native-born myocardial infarction patients in Sweden

Abstract

AbstractBackground and aimsInteractive patient education, referred to as Heart School (HS), is an important part of cardiac rehabilitation (CR) after myocardial infarction (MI), which has been associated with improved outcomes. Little is known about HS attendance among foreign-born patients. The aims were to assess; 1) HS attendance in foreign-born versus native-born patients, 2) the association between the provision of professional interpreters and HS attendance, and 3) secondary prevention goal attainment after MI based on HS attendance.MethodsThe provision of professional interpreters during post-MI follow-up was assessed by a questionnaire sent to all 78 Swedish CR sites. Patient-specific data was retrieved from the SWEDEHEART registry. The association between provision of professional interpreters and HS attendance was estimated with logistic regression models. HS attendance and attainment of secondary prevention goals by country of birth were investigated.ResultsIn total, 8377 patients <75 years (78% male) were included. Foreign-born (19.8%) had higher prevalence of cardiovascular risk factors and were less likely to attend HS (33.7 vs 51.3%, p<0.001), adjusted odds ratio (OR) 0.59 (95% confidence interval (CI) 0.52-0.68), compared with native-born patients. CR centers providing professional interpreters had higher HS attendance among foreign-born (adjusted OR 1.55, 95% CI 1.20-2.01) but not among native-born patients. Attending HS was similarly associated with improved secondary prevention goal attainment in both groups.ConclusionDespite similar positive association between HS attendance and attainment of secondary prevention goals, foreign-born patients attended HS less often. With provision of professional interpreters HS attendance appears to increase in foreign-born patients.