Health status of refugees newly resettled in Denmark.

INTRODUCTION: The municipality of Copenhagen offers general health assessment (GHA) to all newly resettled refugees, conducted at the Section of Immigrant Medicine, Hvidovre Hospital. This study described their disease burden and sociodemographic characteristics. METHODS: In this cross-sectional study, all adult individuals assessed from 1 January 2017 to 30 January 2019 were included. Doctors performed the GHA, including a structured questionnaire, clinical examination and blood testing. RESULTS: In total, 160 refugees were included. Few suffered from communicable diseases (e.g., 1% hepatitis B virus) or other somatic diseases (4% diabetes Type 2). However, deficiencies such as vitamin D deficiency (76%), vitamin B12 deficiency (31%) and anaemia (12%) were frequent. The majority reported headache (54%) or other pain (53%). Furthermore, signs of post-traumatic stress disorder were frequent (33%) and significantly associated with experience of torture, prison and persecution. CONCLUSIONS: The population presented with pertinent health issues such as vitamin deficiencies, mental health issues and symptoms of pain. Few suffered from non-communicable or communicable diseases. Our results suggest that an offer of specialised services at municipality level for all newly resettled refugees may be beneficial. Furthermore, the study underlines the need for more research within the field of refugee health. FUNDING: None. TRIAL REGISTRATION: Ethical approval was obtained from the Capital Region of Denmark and the Danish Patient Safety Authority.

Education of Migrant and Nonmigrant Patients Is Associated With Initiation and Discontinuation of Preventive Medications for Acute Coronary Syndrome.

Background The benefits of preventive medications after acute coronary syndrome are impeded by low medication persistence, in particular among marginalized patient groups. Patient education might increase medication persistence, but the effect is still uncertain, especially among migrant groups. We, therefore, assessed whether use of patient education was associated with medication persistence after acute coronary syndrome and whether migrant background modified the potential associations. Methods and Results A cohort of patients discharged with a diagnosis of acute coronary syndrome (N=33 199) was identified in national registers. We then assessed number of contacts for patient education during a period of 6 months after discharge and the initiation and discontinuation of preventive medications during a period of up to 5 years. Results were adjusted for comorbidity and sociodemographic factors. Three or more contacts for patient education was associated with a higher likelihood of initiating preventive medications, corresponding to adjusted relative risks ranging from 1.12 (95% CI , 1.06-1.18) for statins to 1.39 (95% CI , 1.28-1.51) for ADP inhibitors. Lower risks of subsequent discontinuation were also observed, with adjusted hazard ratios ranging from 0.86 (95% CI , 0.79-0.92) for statins to 0.92 (95% CI , 0.88-0.97) for ß blockers. Stratification and test for effect modification by migrant status showed insignificant effect modification, except for initiation of ADP inhibitors and statins. Conclusions Patient education is associated with higher chance of initiating preventive medications after acute coronary syndrome and a lower long-term risk of subsequent discontinuation independently of migrant status.

Differences in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after acute coronary syndrome among migrants and Danish-born.

Aims: The aim of this article is to assess initiation and discontinuation of preventive medication and use of non-pharmacological prevention interventions after acute coronary syndrome (ACS) among migrants to Denmark compared to the local-born Danish population, taking differences in comorbidity and sociodemographic factors into account. Methods and results: In this large cohort study, we selected the population (n = 33 199) from nationwide registers and followed each individual among migrants and Danish-born 180 days after ACS. We identified the initiation and discontinuation of medications and the initiation and number of contacts for non-pharmacological interventions in the Register of Medicinal Products Statistics and the National Patient Register, and adjusted for comorbidity and sociodemographic factors. Non-Western migrants had lower relative risks for initiating adenosine diphosphate receptor (ADP)- and angiotensin-converting enzyme (ACE)-inhibitors (0.93, CI: 0.90; 0.96, and 0.91, CI: 0.87; 0.96) and patient education (0.95, CI: 0.92; 0.98). Further, non-Western migrants had higher hazard ratios for discontinuing medications (statins: 1.64, CI: 1.45; 1.86, ADP-inhibitors: 1.72, CI: 1.50; 1.97, ß-blockers: 1.52, CI: 1.40; 1.64, and ACE-inhibitors: 1.72, CI: 1.46; 2.02), and fewer contacts for physical exercise and patient education (P < 0.001 and P = 0.011). Conclusion: We identified differences between non-Western migrants and Danish-born in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after ACS. These differences could not be explained by differences in comorbidity or sociodemographic factors.