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

TL;DR

Foreign-born heart attack patients in Sweden attend Heart School less than native-born patients, but providing professional interpreters increases their attendance and improves treatment outcomes.

Contribution

Professional interpreters significantly improve Heart School attendance and treatment outcomes for foreign-born myocardial infarction patients.

Findings

Foreign-born patients attended Heart School less than native-born patients (33.7% vs 51.3%).

Providing professional interpreters increased Heart School attendance among foreign-born patients.

Heart School attendance was linked to better treatment goal fulfillment in both groups.

Abstract

•What is already known - Interactive patient education, referred to as Heart School, is an important part of cardiac rehabilitation after myocardial infarction and it has been associated with improved outcomes.•What this study adds - The provision of professional interpreters at follow-up visits improved Heart School attendance among foreign-born patients. Attending Heart School was associated with better fulfillment of treatment goals in all patients.•How this study might affect research, practice, and policy – Recommendation to provide professional interpreters for foreign-born patients to improve quality and outcomes.

What is already known - Interactive patient education, referred to as Heart School, is an important part of cardiac rehabilitation after myocardial infarction and it has been associated with improved outcomes.

What this study adds - The provision of professional interpreters at follow-up visits improved Heart School attendance among foreign-born patients. Attending Heart School was associated with better fulfillment of treatment goals in all patients.

How this study might affect research, practice, and policy – Recommendation to provide professional interpreters for foreign-born patients to improve quality and outcomes.

Interactive 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.

The 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 the 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.

In total, 8377 patients < 75 years (78 % male) were included. Foreign-born (19.8 %) had a 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.

Despite similar positive association between HS attendance and attainment of secondary prevention goals, foreign-born patients attended HS less often. With the provision of professional interpreters, HS attendance increased in foreign-born patients.

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