scholarly journals POS1495-HPR THE EXPERIENCE OF A RHEUMATOLOGY UNIT DURING THE COVID19 LOCKDOWN: TELEMEDICINE ALLOWS A SAFE FOLLOW UP OF PATIENTS WITH RHEUMATIC DISEASES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1032.1-1032
Author(s):  
K. El Aoufy ◽  
M. R. Melis ◽  
S. Bellando Randone ◽  
J. Blagojevic ◽  
F. Bartoli ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Outpatient Clinic ◽  
Patient Flow ◽  
Diagnostic Procedures ◽  
Patient Assistance ◽  
Rheumatology Unit ◽  
Primary Care Professionals ◽  
Ulcer Treatment ◽  
Rheumatology Practice

Background:In March this year, most of the routine activities were cancelled during the streaming of the pandemic in Italy. This prompted a pragmatic reorganization of the traditional care model of nursing and medicine, to quickly give an efficient clinical response. During the first phase of the pandemic, outpatient visits dropped by more than 60%, forcefully shifting to telemedicine to assure continuity of care despite the lockdown.Objectives:The aim of the present work was to describe the strategy adopted during and immediately after the lockdown to assure the follow up of patients and the maintenance of their treatment in an outpatient “virtual” telemedicine clinic dedicated to RDs.Methods:the patient flow to a rheumatology division during the lockdown was evaluated retrospectively from March to September 2020 in accordance with local restrictions, and three periods are described.Results:653/913 (71.5%), 542/542 (100%) and 1.048/1.048 (100%) infusion activities scheduled were performed at the centre for daily infusion and pre-infusion assessment, respectively during the 1st, 2nd and 3rd period. In the outpatient clinic during the 1st period, 96.96% of the cases was shifted to Telemedicine, which decreased to 52.45% in the 2nd period; while in the 3rd period, 97.6% of the performances were carried out at the clinic. Diagnostic procedures, such as ultrasound, capillaroscopy, and joint injection were generally postponed during the 1st period, reduced drastically during the 2nd and performed regularly during 3rd period. Ulcer treatment and the Clinical Trial Unit never stopped their activity. The flow of the activity of the outpatient clinic and the day hospital is represented as monthly trends in graph 1 (See Graph 1).Conclusion:Our data show the feasibility of Telemedicine in a lockdown condition. Shifting stable patients to Telemedicine has the potentiality to minimize the risk of contagion and allow continuity of care. In the future, the use of Telemedicine for specific clinical uses might assure patient assistance also in non-pandemic conditions.References:[1]Rawaf S, Allen LN, Stigler FL et al. Lessons on the COVID-19 pandemic, for and by primary care professionals worldwide. Eur J Gen Pract. 2020 Dec;26(1):129-133. doi: 10.1080/13814788.2020.1820479. PMID: 32985278.[2]McDougall JA, Ferucci ED, Glover J, et al. Telerheumatology: A Systematic Review. Arthritis Care Res (Hoboken). 2017 Oct;69(10):1546-1557. doi: 10.1002/acr.23153. Epub 2017 Aug 22. PMID: 27863164; PMCID: PMC5436947.[3]Romão VC, Cordeiro I, Macieira C, Oliveira-Ramos F, Romeu JC, Rosa CM, Saavedra MJ, Saraiva F, Vieira-Sousa E, Fonseca JE. Rheumatology practice amidst the COVID-19 pandemic: a pragmatic view. RMD Open. 2020 Jun;6(2):e001314. doi: 10.1136/rmdopen-2020-001314. PMID: 32584782; PMCID: PMC7425193.Characters from table content including title and footnotes:Graph 1.Monthly trend for telemedicine and visits during the SARS Cov2 emergencyAcknowledgements:The project (Telereuma) has been supported by an unrestricted grant of Biogen, BMS, and Novartis.Disclosure of Interests:None declared

Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re- Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012)

2015 ◽  
Vol 24 (3) ◽  
pp. 287-292 ◽  
Author(s):  
Petra A. Golovics ◽  
Laszlo Lakatos ◽  
Michael D. Mandel ◽  
Barbara D. Lovasz ◽  
Zsuzsanna Vegh ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cox Regression ◽  
Diagnostic Procedures ◽  
Population Based ◽  
Disease Course ◽  
Inception Cohort ◽  
Disease Extent ◽  
Cox Regression Analysis ◽  
Hospitalization Rates

Background & Aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of first UC-related hospitalization were 28.6%, 53.7% and 66.2% and of first re-hospitalization were 23.7%, 55.8% and 74.6% after 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a significant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specific disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis. Conclusion: Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.

scholarly journals Nursing Teleconsultation for the Outpatient Management of Patients with Cardiovascular Disease during COVID-19 Pandemic

2021 ◽  
Vol 18 (4) ◽  
pp. 2087
Author(s):  
Vincenzo Russo ◽  
Roberta Cassini ◽  
Valentina Caso ◽  
Chiara Donno ◽  
Annunziata Laezza ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Continuity Of Care ◽  
Medical Intervention ◽  
Lipid Lowering ◽  
Outpatient Management ◽  
Medical Interventions ◽  
Artery Disease ◽  
Clinical Conditions ◽  
Mean Time

Introduction: During the COVID-19 outbreak, non-urgent clinic visits or cardiac interventional procedures were postponed to a later date, and the implementation of telemedicine has guaranteed continuity of care for patients with chronic diseases. The aim of our study was to describe the medical interventions following nursing teleconsultation for the outpatient management of patients with cardiovascular diseases during the COVID-19 pandemic. Materials and Methods: All patients who did not attend the follow-up visit from 4 to 15 April 2020 at our institution and who were re-scheduled due to the COVID-19 lockdown were selected to be enrolled in the study. Each patient was followed by a semi-structured telephonic interview performed by a nurse. The outcomes of our study were to assess the patients’ adherence to nursing teleconsultation and the usefulness of nursing teleconsultation to detect clinical conditions in need of medical intervention. Results: In total, 203 patients (81%) underwent nursing teleconsultation in a mean time of 7 ± 3 days from the outpatient visit lost due to the COVID-19 lockdown. Furthermore, 53 patients (26%) showed poor adherence to nursing teleconsultation. Among the 150 patients (mean age 67 ± 10 years; 68% male) who completed the telephonic interview, the nursing teleconsultation revealed the need of medical intervention in 69 patients (46%), who were more likely at very high cardiovascular risk (77% vs. 48%; p < 0.0003) and who showed a higher prevalence of dyslipidemia (97% vs. 64%; p < 0.0001) and coronary artery disease (75% vs. 48%, p < 0.0008) compared to those not in need of any intervention. The up-titration of the lipid-lowering drugs (n: 32, 74%) was the most frequent medical intervention following the nursing teleconsultation. The mean time between the nursing teleconsultation and the date of the rescheduled in-person follow-up visit was 164 ± 36 days. Conclusions: Nursing teleconsultation is a simple and well-tolerated strategy that ensures the continuity of care and outpatient management for patients with cardiovascular diseases during the COVID-19 pandemic.

Patients with shoulder pain referred to specialist care; treatment, predictors of pain and disability, emotional distress, main symptoms and sick-leave: a cohort study with a six-months follow-up

2020 ◽  
Vol 20 (4) ◽  
pp. 775-783
Author(s):  
Kaia B. Engebretsen ◽  
Jens Ivar Brox ◽  
Niels Gunnar Juel
Keyword(s):  
Clinical Trials ◽  
Cohort Study ◽  
Sick Leave ◽  
Shoulder Pain ◽  
Emotional Distress ◽  
Outpatient Clinic ◽  
Treatment Duration ◽  
Specialist Care ◽  
Yellow Flags

AbstractObjectivesRecommendations for referral of patients with shoulder pain from primary to specialist care are mainly clinical. Several patients are referred without meeting these criteria for referral, whereas some are referred for a second opinion although surgery is not recommended. The aims of this study were to describe a shoulder pain cohort in specialist healthcare according to demographic data, clinical, and psychological factors; evaluate changes in pain and disability, distress and main symptoms from baseline to six-month follow-up; and to assess predictors of pain and disability, changes in the main symptoms and sick-leave at six-months. Results were compared to previous randomised trials conducted at the same clinic in patients with subacromial shoulder pain.MethodsThis prospective study included 167 patients from an outpatient clinic in specialist healthcare with shoulder pain for more than 6 weeks. Clinical (pain duration, intensity, pain sites), sociodemographic (age, gender, educational level, work status) and psychological variables (emotional distress (HSCL-10), fear of pain, screening of “yellow flags”, health-related quality of life) were collected. Shoulder pain and disability (SPADI-score) were assessed and the patients were asked about their outcome expectation and to predict their status of their shoulder problem the next month. They underwent a clinical interview, a clinical assessment of shoulder function and orthopaedic tests for diagnostic purposes. After six months they received a questionnaire with main variables.ResultsOf the 167 patients (55% women), 50% had symptoms for more than 12 months and 37 (22%) were on sick-leave. Characteristics were in general comparable to patients previously included in clinical trials at the same department. The SPADI-score was 46 (23) points. Mean emotional distress was within the normal range (1.7 (SD 0.6)). More than 80% had received treatment before, mainly physiotherapy in addition to the GPs treatment. One hundred and thirty-seven patients (82%) were re-referred to physiotherapy, 74 (44%) in the outpatient clinic specialist healthcare, and 63 (38%) in primary care. One hundred and eighteen (71%) answered the follow-up questionnaire. Mean change in SPADI-score was 10.5 points (95% CI (6.5–14.5)), and 29% of the patients improved more than the smallest detectable difference (SDD). The percentage sick-listed was 19.5%, and mean change in main symptoms (−9 to +9) was 3.4 (SD 3.9). The subgroup of patients receiving physiotherapy in outpatient specialist care did not show any significant change in the main variables. The prediction models suggested that a lower level of education, more fear of pain and a high baseline SPADI-score, predicted a higher SPADI-score at follow-up. A high baseline HSCL-10 score was the only significant predictor for a high HSCL-10 score. At follow-up, less pain at rest predicted more change in main symptoms and more yellow flags (a higher score on the Örebro screening test) predicted sick-leave.ConclusionsWithin the limitations of a cohort study, patients with persistent shoulder pain referred to an outpatient specialist clinic had similar baseline characteristics but shorter treatment duration, inferior clinical results and predictors somewhat different compared with previous clinical trials conducted at the same clinic. The study raises some questions about the effectiveness of the routines in daily clinical practice, the selection of patients, the treatment duration and content.

scholarly journals AB0702 PITFALLS IN THE DIAGNOSIS OF COVID-19 – EXPERIENCES FROM A RHEUMATOLOGY OUTPATIENT CLINIC

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1383.2-1383
Author(s):  
S. G. Werner ◽  
H. E. Langer ◽  
P. Höhenrieder ◽  
R. Chatelain
Keyword(s):  
Outpatient Clinic ◽  
Virus Disease ◽  
Disease Onset ◽  
Signs And Symptoms ◽  
Contact Tracing ◽  
Igg Antibodies ◽  
Antibody Testing ◽  
Antibody Titers ◽  
Rheumatology Outpatient

Background:PCR (Polymerase Chain Reaction) is generally considered the gold standard for confirming the diagnosis in the early stages of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. However, in our rheumatology outpatient clinic we observed a significant discrepancy between clinical evidence of COVID-19 and PCR results.Objectives:Aim of this retrospective study was to analyze the significance of PCR and serologic tests in the diagnosis of COVID-19 (Corona Virus Disease 2019) in a cohort of patients with rheumatic diseases.Methods:Between March 2020 and January 2021, 35 patients with a history of established COVID-19 or typical signs and symptoms were identified on the occasion of a routine rheumatology follow-up examination in our institution. Previous diagnostic work-up in external facilities (results of PCR or antibody testing, imaging) was documented. Antibody ELISA-tests (IgG, IgA, IgM, Euroimmun) were performed in patients reporting typical signs and symptoms of COVID-19 in the past.Results:PCR diagnostics had been performed in 15/35 patients (43%), in 13/35 (39%) at the onset of the first symptoms, in 2 subjects only 2 months later. PCR was positive in 7/13 (54%) of those tested early, but negative in the two patients tested later. In 29/35 patients (83%) SARS-CoV-2-ELISA tests were performed on the occasion of the routine rheumatologic examination (interval between first symptoms and testing on average 98 days, median86, range 4-283 days). In two of the initially negative individuals the second PCR was positive. ELISA tests were positive in all patients. SARS-CoV-2 IgM antibodies were positive in only two patients (however 55 and 71 days after disease onset), n=8/29 (28%) IgG only, n=9/29 (31%) IgG and IgA, n=12/29 (41%) IgA only. In these subjects, IgG antibodies did not develop even in the further course. Antibody titers were in part very high, but in part also very low (only just above the normal value), so even low titers were diagnostic obviously. In all patients with negative PCR, ELISA was positive and retrospectively led to confirmation of the diagnosis. Only in 13/35 patients (37%) diagnosis had been made with the onset of the first symptoms or in the course of clinically manifest disease and had led to appropriate quarantine measures and contact tracing by the health authorities. In contrast, in the majority of patients (63%), the diagnosis of COVID-19 infection was only made retrospectively on the occasion of a routine rheumatologic follow-up. However, 5 of these 22 patients (23%) had quarantined themselves during the symptomatic phase. Titer histories were available from 12 patients. The titer became negative in 7 patients, after a mean of 188 days (median 202, min 51, max 296 days), and remained positive in 5 individuals (mean 190 days, median 191, min 122, max 260 days). The change of the titer was independent of disease severity or antirheumatic therapy.Conclusion:The results suggest that the importance of PCR in the diagnosis of COVID-19 may be overestimated. Therefore, antibody testing for SARS-CoV-2 should be performed in cases of clinical suspicion and negative PCR. In antibody diagnostics, special features were observed compared to other viruses, in particular, in some patients only low antibody titers or the absence of seroconversion with lack of development of IgG antibodies. Normalization of antibody titers in some patients supports the recommendation to vaccinate even after expired COVID-19 disease.Disclosure of Interests:None declared

scholarly journals Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eric D. Moyer ◽  
Erik B. Lehman ◽  
Matthew D. Bolton ◽  
Jennifer Goldstein ◽  
Ariana R. Pichardo-Lowden
Keyword(s):  
Blood Glucose ◽  
Continuity Of Care ◽  
Clinical Documentation ◽  
Stress Hyperglycemia ◽  
Optimal Care ◽  
Continuity Clinic ◽  
Altered Glucose ◽  
Discharge Summaries

AbstractStress hyperglycemia (SH) is a manifestation of altered glucose metabolism in acutely ill patients which worsens outcomes and may represent a risk factor for diabetes. Continuity of care can assess this risk, which depends on quality of hospital clinical documentation. We aimed to determine the incidence of SH and documentation tendencies in hospital discharge summaries and continuity notes. We retrospectively examined diagnoses during a 12-months period. A 3-months representative sample of discharge summaries and continuity clinic notes underwent manual abstraction. Over 12-months, 495 admissions had ≥ 2 blood glucose measurements ≥ 10 mmol/L (180 mg/dL), which provided a SH incidence of 3.3%. Considering other glucose states suggestive of SH, records showing ≥ 4 blood glucose measurements ≥ 7.8 mmol/L (140 mg/dL) totaled 521 admissions. The entire 3-months subset of 124 records lacked the diagnosis SH documentation in discharge summaries. Only two (1.6%) records documented SH in the narrative of hospital summaries. Documentation or assessment of SH was absent in all ambulatory continuity notes. Lack of documentation of SH contributes to lack of follow-up after discharge, representing a disruptor of optimal care. Activities focused on improving quality of hospital documentation need to be integral to the education and competency of providers within accountable health systems.

scholarly journals Impact of hospitalization for checking medication adherence due to resistant and refractory hypertension suspicious on short and mid-term blood pressure control

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Pio-Abreu ◽  
F Trani-Ferreira ◽  
G.V Silva ◽  
L.A Bortolotto ◽  
L Drager
Keyword(s):  
Blood Pressure ◽  
Hospital Discharge ◽  
Outpatient Clinic ◽  
Antihypertensive Drugs ◽  
Outpatient Visit ◽  
Target Organ Damage ◽  
Refractory Hypertension ◽  
Gold Standard Method ◽  
Medication Intake

Abstract Background Resistant (HR) and refractory hypertension (HRef) are associated with increased cardiovascular events and target-organ damage. However, appropriate HR and HRef diagnosis require good drug adherence. In this context, the “gold standard” method for assessing adherence is supervised medication intake. However, it is not clear the real utility of supervised medication intake in clinical practice. Purpose To evaluate whether hospitalization for confirming anti-hypertensive adherence in patients with HR and HRef may impact blood pressure (BP) control after hospital discharge in patients with HR or HRef suspicious at a tertiary outpatient clinic. Methods We recruited consecutive patients with HR or HRef suspicious admitted to the Hospital for confirming treatment adherence. HR was defined as uncontrolled office BP (≥140 and/or ≥90mmHg) despite using ≥3 classes at optimal doses (one of them being diuretic) or controlled BP using ≥4 classes. HRef was defined as no BP control despite using ≥5 antihypertensive drugs. Patients with suspected HRef who did not meet the criteria but full field the HR definition were named HRNoRef. During hospitalization, all patients used low sodium diet and had supervised taking of prescribed drugs by the medical team aiming BP control. We defined not only the rate of adherence and HF/HRef status but also BP and number of antihypertensive drugs at hospital discharge and in the two first return outpatient's visits. Results We studied a total of 83 patients with suspected HR/HRef (age 53±14 years; 76% females; pre-hospitalization systolic and diastolic BP: 177±28 and 106±21mmHg, respectively). Of these, 68.7% (57 patients) had suspected HRef in the outpatient clinic. The average number of antihypertensive drugs on admission was 5.3±1.3 classes. After hospitalization, the overall frequency of HR fell to 80% (66 patients). The average number of antihypertensive drugs at hospital discharge as well as systolic and diastolic BP was 4.5±1.3 classes, 131±17mmHg and 80±12mmHg, respectively (p&lt;0.001 vs. pre-hospitalization for all comparisons). Among the HR types, HRef was confirmed in only 27 patients (32.5%). During the outpatient follow-up, the patients remained with lower number of antihypertensive drugs as well as lower systolic and diastolic BP at first outpatient visit (mean returned time: 2.1±1.7months) and second outpatient visit post-discharge (mean returned time 7.1±2.6months) as compared to pre-hospitalization data: First visit: 4.3±1.2 classes, systolic: 152±24mmHg, diastolic BP: 89±17mmHg; second visit: 4.5±1.3 classes, systolic: 150±26mmHg, diastolic BP: 89±15mmHg; (p&lt;0.001 vs. pre-hospitalization for all comparisons). Conclusion Supervised medication intake during hospitalization may help not only to define the HR and HRef status but also to have impact on the number of antihypertensive drugs and lower BP values at short and mid-term follow-up. Funding Acknowledgement Type of funding source: None

scholarly journals 688 Rapid Implementation of Virtual Fracture Clinic During COVID 19 Reduces Both Face-To-Face Appointments and Facilitates Rapid Feedback and Education to Be Delivered to The Emergency Department

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Havenhand ◽  
L Hoggett ◽  
A Bhutta
Keyword(s):  
Emergency Department ◽  
Patient Flow ◽  
Prospective Data ◽  
Fracture Clinic ◽  
Face To Face ◽  
Return Rates ◽  
Acute Hospitals ◽  
Virtual Fracture Clinic ◽  
Improve Patient

Abstract Introduction COVID-19 has dictated a shift towards virtual clinics. Pennine Acute Hospitals NHS Trust serves over a million patients with a significant number of face-to-face fracture clinics. Introduction of a Virtual Fracture Clinic (VFC) reduces hospital return rates and improves patient experience. The referral data can be used to give immediate monthly feedback to the referring department to further improving patient flow. Method Prospective data was collected for all referrals to VFC during March 2020. Data included referral diagnosis, actual diagnosis, referrers grade, and final outcome. Results 630 referrals were made to VFC. 347 (55%) of those referrals were directly discharged without the need for physical consultation. Of these 114 (32%) were injuries which can be discharged by the Emergency Department with an advice leaflet using existing pathways. Of the remaining discharges 102 (29%) were query fractures or sprains; and 135 (39%) were minor fractures; which needed only advice via a letter and no face to face follow up. Conclusions Implementation of VFC leads to a decrease in physical appointments by 55% saving 347 face to face appointments. The new system has also facilitated effective audit of referrals in order to further improve patient flow from the Emergency Department via feedback mechanisms and education.

scholarly journals Factors related to perceived continuity of care in hospitalized cardiac patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Safstrom ◽  
T.J Jaarsma ◽  
L.N Nordgren ◽  
M.L Liljeroos ◽  
A.S Stomberg
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Care ◽  
Continuity Of Care ◽  
Perceived Control ◽  
Care Utilization ◽  
Funding Source ◽  
Patient Reported

Abstract Background Since healthcare systems are increasingly complex and often fragmented, continuity of care after hospitalization is a priority to increase patient safety and satisfaction. Aim Describe factors related to continuity of care in patients hospitalized due to cardiac conditions. Methods This cross-sectional multicenter study enrolled patients 6 weeks after hospitalization due to cardiac conditions. A total of 993 patients were included (mean age 72.2 (SD 10.4), males 66%) with AMI (35%), AF (25%), angina (21%) and HF (17.3%). Patients completed the Patient Continuity of Care Questionnaire, a questionnaire based on the definition that continuity of care is “the extent to which a series of health care services is experienced as connected and coherent and is consistent with a patient's health needs and personal circumstances”. The total score of the questionnaire ranges from 6 to 30, higher score indicating higher continuity and a score &lt;24 indicating insufficient continuity. Cronbach's alpha on the total PCCQ was 0.94. Correlations between PCCQ and quality of life, depression, anxiety, perceived control and health care utilization were estimated using spearman rang correlation. Results Insufficient continuity of care ranged between 47% to 59% in the different diagnosis groups, which the highest continuity in the AMI group and lowest in patients with atrial fibrillation. In patients hospitalized due to AMI (n=355, mean age 71 (± 11), 70% men), continuity of care was related to higher perceived control, higher quality of life, a good financial situation, being a man, no symptoms of anxiety or depression (ᚹ range 0.17–0.26 p≤0.002). A low score on the PCCQ were associated with follow-up visit to a nurse in primary care after hospitalization (ᚹ −0.12 p=0.033). In patients hospitalized due to angina (n=210, mean age 73 (± 9), 74% men), continuity of care was related to higher perceived control, higher quality of life and no depressive symptoms (ᚹ range between 0.20 and 0.26 p=0.005). In patients with AF, (n=255, mean age 71 (± 10.), 58% men), continuity of care was related to having had contact by telephone with a nurse-led AF clinic, higher perceived control, higher quality of life and not being depressed (ᚹ range between 0.14–0.25 p=0.03). In patients with HF, (n=173, mean age 77 (±8) 59% men), continuity was related to male ender, younger age, follow-up in a nurse-led HF clinic and not being anxious (ᚹ range between 0.16 and 0.22 p=0.004–0.047). Low total score on PCCQ correlated to having had telephone contact with nurse in primary care (ᚹ −0.24 p=0.002). Conclusion Almost half of all patient reported insufficient continuity of care. Perceived control, quality of life, and symptoms of depression were related to higher continuity of care in all diagnose groups except heart failure. Further, there was a correlation between continuity and follow-up visits or contact by telephone with nurse-led clinics in all diagnose groups except angina. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Medical Research Council of Southeast Sweden, Centre for Clinical Research Sörmland

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