Adherence to antiplatelet therapy after percutaneous coronary intervention

Pinnarelli, Luigi; Mayer, Flávia; Bauleo, Lisa; Agabiti, Nera; Kirchmayer, Ursula; Belleudi, Valeria; Martino, Mirko Di; Autore, Camillo; Ricci, Roberto; Violini, Roberto; Fusco, Danilo; Davoli, Marina; Perucci, Carlo A.

doi:10.2459/jcm.0000000000000070

Cited by 6 publications

(1 citation statement)

References 36 publications

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“…Both our research and those previously published [27][28][29][30][31][32][33][34][35] suggest that the practical implementation of these guidelines has a number of limitations. It is advisable to conduct further research on the determinants of readiness for discharge and implementation of the therapeutic plan.…”

Section: Discussionmentioning

confidence: 63%

The impact of knowledge and effectiveness of educational intervention on readiness for hospital discharge and adherence to therapeutic recommendations in patients with acute coronary syndrome

Michalski

Kasprzak

Siedlaczek

et al. 2020

Medical Research Journal

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Introduction: ESC guidelines emphasize the importance of educating patients after acute coronary syndromes aimed at familiarizing the patient with the essence of the disease, the principles of self-control and self-care as well as actions enhancing health maintenance. Aim: The aim of the study was to assess the impact of knowledge and effectiveness of educational intervention on readiness for discharge from the hospital and compliance with therapeutic recommendations six months after discharge. Material and methods: The study group consisted of 218 patients (28.9% women and 71.1% men) aged 31 to 90 years (63.0 ± 11.24) treated with coronary angioplasty for myocardial infarction. The effectiveness of educational intervention was assessed by comparing patients' knowledge on the day of admission (1KE) and discharge from the hospital (2KE). Knowledge was assessed in 3 aspects: knowledge of symptoms, knowledge of the disease, and knowledge of prevention. Education was provided between 1KE and 2KE based on the brochure entitled "Myocardial Infarction". The level of knowledge on the day of discharge and the increase in knowledge obtained after education (∆KE) were referred to the level of Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD-MIS) and to the level of adherence in chronic diseases scale (ACDS). Results: As a result of the education carried out between 1KE and 2KE, a significant increase in knowledge was obtained (p < 0.05). There was no correlation between ΔKE and RHD-MIS. However, it was shown that a higher level of knowledge at discharge (2KE) was associated with a higher RHD-MIS result (R = 0.17; p = 0.01). The highest impact on the RHD-MIS result was due to the level of knowledge of disease symptoms in 2KE: 75.5 ± 19.5%, 76.4 ± 21.1%, 85.8 ± 16.4% for low, medium and high RHD-MIS results (p = 0.002) ; R = 0.15; p = 0.0003. Knowledge of the disease symptoms in 2KE was associated with the patient's expectations in RHD-MIS-a higher level of knowledge was associated with higher patient expectations, respectively: 73.2 ± 21.7%, 80.0 ± 18.5%, 82.9 ± 19.2 for low, medium and high RHD-MIS (p = 0.02); R = 0.19; p = 0.006. There was no correlation between ΔKE or 2KE and ACDS results 6 months after discharge. Conclusions: The educational brochure is an effective tool in improving patients' level of knowledge. Better knowledge of the symptoms of coronary artery disease and myocardial infarction is associated with a higher degree of readiness for discharge from the hospital but does not affect the observance of therapeutic recommendations in the field of pharmacotherapy after 6 months.

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Section: Discussionmentioning

confidence: 63%

The impact of knowledge and effectiveness of educational intervention on readiness for hospital discharge and adherence to therapeutic recommendations in patients with acute coronary syndrome

Michalski

Kasprzak

Siedlaczek

et al. 2020

Medical Research Journal

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Same-Day Discharge After Percutaneous Coronary Intervention

et al. 2016

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Combination evidence-based therapy is effective in the oldest ‘old patients’ following myocardial infarction. The “Salute e Benessere nell’Anziano” (SeBA) observational study

Bari

Esposti²,

Veronesi³

et al. 2016

Intern Emerg Med

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Antiplatelet drugs, statins, angiotensinogen-converting enzyme inhibitors or angiotensin-II receptor blockers, and β-blockers improve survival following myocardial infarction (MI). However, in old age they are under-prescribed, and their effectiveness in combination regimens is unproven. The aim of the study was to evaluate prescription of recommended cardiovascular drug classes and impact of a combination regimen on long-term mortality and hospitalizations. Records of 65+ years MI survivors, discharged from hospitals in four Local Health Units in Italy, were selected from administrative databases and analyzed. All-cause mortality and cardiovascular re-hospitalization in 12 months were compared across participants prescribed 0, 1, 2, 3, or 4 recommended drug classes. Out of 2626 participants (56 % men, 25 % aged 85+ years), 42 % were prescribed all, 14 % none of the recommended drug classes. The prescription rate decreased with advancing age. At all ages, mortality decreased with increasing number of drug classes prescribed: in participants aged 85+ years, adjusted hazard ratios (95 % confidence interval) for death were 0.74 (0.47-1.17), 0.52 (0.33-0.82), 0.30 (1.19-0.48), and 0.33 (0.20-0.53) for 1, 2, 3, and 4 classes prescribed, compared with none. The risk of cardiovascular re-hospitalizations decreased with an increasing number of drug classes prescribed through the age of 84 years. After MI, a combination regimen of recommended drug classes prevents long-term mortality at any age, and cardiovascular re-hospitalizations through the age of 84. Enhancing compliance with treatment guidelines may reduce the burden of mortality and hospitalizations in older MI survivors.

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Adherence to antiplatelet therapy after percutaneous coronary intervention

Cited by 6 publications

References 36 publications

The impact of knowledge and effectiveness of educational intervention on readiness for hospital discharge and adherence to therapeutic recommendations in patients with acute coronary syndrome

The impact of knowledge and effectiveness of educational intervention on readiness for hospital discharge and adherence to therapeutic recommendations in patients with acute coronary syndrome

Same-Day Discharge After Percutaneous Coronary Intervention

Combination evidence-based therapy is effective in the oldest ‘old patients’ following myocardial infarction. The “Salute e Benessere nell’Anziano” (SeBA) observational study

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