Impact of Deferred Clinic Visits on Patients With Cardiovascular Comorbidities: A Prospective Cohort Study

NCT07050407 | Completed

• 2 other identifiers: 2020.159CUHK-NTEC CREC
• Study Type: observational
• Target: 458
• Locations: 1 country
• Sites: 1

Brief Summary

This is a prospective cohort study examining the effects of prolonged clinic visit on patient's cardiovascular (CV) risk factors control and whether it will increase the risk of adverse clinical events. This study leveraged the clinic visit deferment arrangement implemented during the COVID-19 pandemic to examine the difference in CV risk factors between patients who deferred and a control group who attended their clinic visit as scheduled.

Conditions

Cardiovascular Risk Factor

Keywords

medical out-patient visit; COVID-19 outbreak; CV risk factors control

Outcome Measures

Primary Outcomes (1)

• uncontrolled CVRF

  uncontrolled CVRF, defined as the presence of any of the following: uncontrolled DM with HbA1c \>7%, uncontrolled hypertension with office systolic blood pressure (SBP)\>130mmHg and/or diastolic blood pressure (DBP) \>80mmHg, or uncontrolled dyslipidaemia defined as low-density-lipoprotein (LDL) \>1.8mmol/L.

  through study completion, an average of 1 year

Secondary Outcomes (7)

• unscheduled emergency service visit or hospitalization

  through study completion, an average 2 years

• major adverse cardiovascular events (MACE)

  through study completion, an average 2 years

• all-cause death

  through study completion, an average 2 years

• HbA1c

  through study completion, an average 2 years

• blood pressure

  through study completion, an average 2 years

Study Arms (2)

Deferred

Patients who deferred their appointment

Control

patients who attended their appointment as scheduled

Eligibility Criteria

• Age: 19 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Study participants will be recruited primarily form Medical Specialist Outpatient Clinics of the Prince of Wales Hospital, a tertiary regional teaching hospital in Hong Kong.

You may qualify if:

• Patients who attend outpatient clinics at the Prince of Wales Hospital
• Patients who are followed up at the clinics for at least 1 CV risk factors, namely diabetes, hypertension, dyslipidaemia, or history of vascular events including cerebrovascular accidence, ischemic heart disease or peripheral vascular disease.

You may not qualify if:

• New referrals to the outpatient clinics
• Unstable patients such as patients with recent hospitalization within 3 months to the interviewing date
• Patients with complex medical problems indicated by Charlson Comorbidity Index of equal or more than 5
• Patients whose active medical problems are not cardiovascular related
• Patient who are taking vitamin K antagonist
• Patients who defaulted their follow-up appointment with no new appointment on record.

Sponsors & Collaborators

• Chinese University of Hong Kong: lead

Study Sites (1)

Prince of Wales Hospital

Hong Kong, Shatin, 0000, Hong Kong

Location

Related Publications (7)

• Singh GM, Danaei G, Farzadfar F, Stevens GA, Woodward M, Wormser D, Kaptoge S, Whitlock G, Qiao Q, Lewington S, Di Angelantonio E, Vander Hoorn S, Lawes CM, Ali MK, Mozaffarian D, Ezzati M; Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group; Asia-Pacific Cohort Studies Collaboration (APCSC); Diabetes Epidemiology: Collaborative analysis of Diagnostic criteria in Europe (DECODE); Emerging Risk Factor Collaboration (ERFC); Prospective Studies Collaboration (PSC). The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis. PLoS One. 2013 Jul 30;8(7):e65174. doi: 10.1371/journal.pone.0065174. Print 2013.

  PMID: 23935815 BACKGROUND

• Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment. Lancet Diabetes Endocrinol. 2014 Aug;2(8):634-47. doi: 10.1016/S2213-8587(14)70102-0. Epub 2014 May 16.

  PMID: 24842598 BACKGROUND

• Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC Jr, Sperling L, Virani SS, Yeboah J. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Jun 18;139(25):e1082-e1143. doi: 10.1161/CIR.0000000000000625. Epub 2018 Nov 10.

  PMID: 30586774 BACKGROUND

• Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, Rossing P, Tsapas A, Wexler DJ, Buse JB. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018 Dec;41(12):2669-2701. doi: 10.2337/dci18-0033. Epub 2018 Oct 4.

  PMID: 30291106 BACKGROUND

• Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15;71(19):e127-e248. doi: 10.1016/j.jacc.2017.11.006. Epub 2017 Nov 13. No abstract available.

  PMID: 29146535 BACKGROUND

• Sherman L, Pelter MA, Deamer RL, Duan L, Batech M. Association between encounter frequency and time to blood pressure control among patients with newly diagnosed hypertension: a retrospective cohort study. J Clin Hypertens (Greenwich). 2018 Mar;20(3):429-437. doi: 10.1111/jch.13223. Epub 2018 Feb 16.

  PMID: 29450983 BACKGROUND

• Morrison F, Shubina M, Turchin A. Encounter frequency and serum glucose level, blood pressure, and cholesterol level control in patients with diabetes mellitus. Arch Intern Med. 2011 Sep 26;171(17):1542-50. doi: 10.1001/archinternmed.2011.400.

  PMID: 21949161 BACKGROUND

Related Links

• WHO Director-General's opening remarks at the Mission briefing on COVID-19 - 12 March 2020

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 2 Years
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assistant professor

Study Record Dates

• First Submitted: June 5, 2025
• First Posted: July 3, 2025
• Study Start: April 1, 2020
• Primary Completion: January 31, 2022
• Study Completion: June 30, 2024
• Last Updated: July 3, 2025

Record last verified: 2025-06

Locations

HK (1)