Can an individualized adherence education program delivered by nurses improve therapeutic adherence in elderly people with acute myocardial infarction?: A randomized controlled study

Calvo, Elena; Edo, Sílvia; Castillo, Rodrigo; César, Elisabeth; Domene, Gerard; Gómez, Alberto Gómez; Guerrero, Carmen; Andreu‐Periz, Lola; Gómez‐Hospital, Joan Antoni; Arizá-Solé, Albert

doi:10.1016/j.ijnurstu.2021.103975

Cited by 14 publications

(13 citation statements)

References 37 publications

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“… 28 Conversely, in a randomized trial enrolling older patients with low adherence and comparing usual care with and without a nursing intervention (assessment of problems with adherence and targeted education) at 3 months post AMI found that the intervention almost doubled adherence (measured through self-report and pharmacy records) from 22% to 52%. 29 To our knowledge, the trial reported herein is the only one deploying an SDM intervention to improve adherence in the post AMI period, joining a body of evidence that offers an inconsistent effect of SDM on adherence and outcomes. 30–34 Future studies that aim to improve fidelity to post AMI treatments may need to enroll patients at highest risk of nonadherence and design, implement, and evaluate interventions that address both structural and volitional factors while addressing the practical challenges of making treatment programs fit in daily life routines.…”

Section: Discussionmentioning

confidence: 96%

Shared Decision-Making for Patients Hospitalized with Acute Myocardial Infarction: A Randomized Trial

Branda¹,

Kunneman²,

Meza-Contreras³

et al. 2022

PPA

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Objective Adherence to guideline-recommended medications after acute myocardial infarction (AMI) is suboptimal. Patient fidelity to treatment regimens may be related to their knowledge of the risk of death following AMI, the pros and cons of medications, and to their involvement in treatment decisions. Shared decision-making may improve both patients’ knowledge and involvement in treatment decisions. Methods In a pilot trial, patients hospitalized with AMI were randomized to the use of the AMI Choice conversation tool or to usual care. AMI Choice includes a pictogram of the patient’s estimated risk of mortality at 6 months with and without guideline-recommended medications, ie, aspirin, statins, beta-blockers, and angiotensin-converting enzyme inhibitors. Primary outcomes were patient knowledge and conflict with the decision made assessed via post-encounter surveys. Secondary outcomes were patient involvement in the decision-making process (observer-based OPTION12 scale) and 6-month medication adherence. Results Patient knowledge of the expected survival benefit from taking medications was significantly higher (62% vs 16%, p <0.0001) in the AMI Choice group (n = 53) compared to the usual care group (n = 53). Both groups reported similarly low levels of conflict with the decision to start the medications (13 (SD 24.2) vs 16 (SD 22) out of 100; p =0.16). The extent to which clinicians in the AMI Choice group involved their patients in the decision-making process was high (OPTION12 score 53 out of 100, SD 12). Medication adherence at 6-months was relatively high in both groups and not different between groups. Conclusion The AMI Choice conversation tool improved patients’ knowledge of their estimated risk of short-term mortality after an AMI and the pros and cons of treatments to reduce this risk. The effect on patient fidelity to recommended medications of using this SDM tool and of SDM in general should be tested in larger trials enrolling patients at high risk for nonadherence. Trial Registration Number NCT00888537.

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Section: Discussionmentioning

confidence: 96%

Shared Decision-Making for Patients Hospitalized with Acute Myocardial Infarction: A Randomized Trial

Branda¹,

Kunneman²,

Meza-Contreras³

et al. 2022

PPA

View full text Add to dashboard Cite

show abstract

“…29 Conversely, in a randomized trial enrolling older patients with low adherence and comparing usual care with and without a nursing intervention (assessment of problems with adherence and targeted education) at 3 months post AMI found that the intervention almost doubled adherence (measured through self-report and pharmacy records) from 22% to 52%. 30 To our knowledge, the trial reported herein is the only one deploying an SDM intervention to improve adherence in the post AMI period, joining a body of evidence that offers an inconsistent effect of SDM on adherence and outcomes. 31-35 Future studies that aim to improve fidelity to post AMI treatments may need to enroll patients at highest risk of nonadherence and design, implement, and evaluate interventions that address both structural and volitional factors while addressing the practical challenges of making treatment programs fit in daily life routines.…”

Section: Discussionmentioning

confidence: 96%

Shared Decision Making for Patients Hospitalized with Acute Myocardial Infarction. A Randomized Trial

Branda

Kunneman

Meza-Contreras

et al. 2022

Preprint

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Objective: Adherence to guideline-recommended medications after acute myocardial infarction (AMI) is suboptimal. Patient fidelity to treatment regimens may be related to their knowledge of the risk of death following AMI, the pros and cons of medications, and to their involvement in treatment decisions. Shared decision making may improve both patient knowledge and involvement in treatment decisions. Methods: In a pilot trial, patients hospitalized with AMI were randomized to the use of the AMI Choice conversation tool or to usual care. AMI Choice includes a pictogram of patient estimated risk of mortality at 6 months with and without guideline–recommended medications, i.e., aspirin, statins, beta–blockers, and angiotensin–converting enzyme inhibitors. Primary outcomes were patient knowledge and conflict with the decision made assessed via post–encounter surveys. Secondary outcomes were patient involvement in the decision-making process (observer–based OPTION12 scale) and 6–month medication adherence. Results: Patient knowledge of the expected survival benefit from taking medications was significantly higher (62% vs. 16%, p<0.0001) in the AMI Choice group (n=53) compared to the usual care group (n=53). Both groups reported similarly low levels of conflict with the decision to start the medications (13 (SD 24.2) vs. 16 (SD 22) out of 100; p=.16). The extent to which clinicians in the AMI Choice group involved their patients in the decision–making process was high (OPTION12 score 53 out of 100, SD 12). Medication adherence at 6–months was relatively high in both groups and not different between groups. Conclusions: The AMI Choice conversation tool improved patient knowledge of their estimated risk of short–term mortality after an AMI and the pros and cons of treatments to reduce this risk. The effect on patient fidelity to recommended medications of using this SDM tool and of SDM in general should be tested in larger trials enrolling patients at high risk for nonadherence.

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“…[ 17 ] The objective of the risk awareness strengthening management combined with cardiac rehabilitation nursing mode is to enhance patients’ risk recognition and prevention consciousness, evaluate potential risks, analyze the probability and severity of the risks, take appropriate preventive measures, control the identified risks, reduce the probability and severity of harm caused by the risks. [ 18 , 19 ]…”

Section: Discussionmentioning

confidence: 99%

“…Observation group (n = 51) measures, control the identified risks, reduce the probability and severity of harm caused by the risks. [18,19] Many studies have explored the association between medication adherence and various related scales, including the Morisky Green score and MPR. The Morisky Green score is a questionnaire designed to assess an individual adherence to a prescribed medication regimen.…”

Section: After the Interventionmentioning

confidence: 99%

Application of intensive management of risk awareness combined with cardiac rehabilitation nursing in elderly patients with acute myocardial infarction and heart failure

Yin,

Huang,

Lin

2024

Medicine

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The aim of this study is to assess the impact of intensive risk awareness management along with cardiac rehabilitation nursing in elderly patients with acute myocardial infarction and heart failure. We selected 101 elderly patients with acute myocardial infarction and heart aging treated from January 2022 to March 2023. They were divided into control and observation groups based on hospitalization numbers. The control group (n = 50) received routine nursing, while the observation group (n = 51) received intensive risk awareness management and cardiac rehabilitation nursing. We compared medication possession ratio (MPR), cardiac function, self-care ability scale scores, quality-of-life, incidents, and satisfaction between the 2 groups. Before intervention, there was no significant difference in MPR values between the 2 groups (P > .05). After intervention, MPR values increased in both groups, with a greater increase in the observation group (P < .05). Cardiac function showed no significant difference before intervention (P > .05), but after intervention, the observation group had lower left ventricular end-systolic and diastolic diameters and higher left ventricular ejection fraction compared to the control group (P < .05). Self-care skills, health knowledge, self-responsibility, and self-concept scores improved in both groups after intervention, with higher scores in the observation group (P < .05). The observation group had higher scores in various quality-of-life domains (P < .05). The total incidence of adverse events was lower in the observation group (5.88%) compared to the control group (20.00%) (P < .05). Patient satisfaction was significantly higher in the observation group (96.08%) than in the control group (84.00%) (P < .05). Intensive risk awareness management combined with cardiac rehabilitation nursing in elderly patients with acute myocardial infarction and heart aging can enhance medication compliance, improve quality-of-life, enhance self-care abilities, boost cardiac function, reduce incidents, and increase patient satisfaction.

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Can an individualized adherence education program delivered by nurses improve therapeutic adherence in elderly people with acute myocardial infarction?: A randomized controlled study

Cited by 14 publications

References 37 publications

Shared Decision-Making for Patients Hospitalized with Acute Myocardial Infarction: A Randomized Trial

Shared Decision-Making for Patients Hospitalized with Acute Myocardial Infarction: A Randomized Trial

Shared Decision Making for Patients Hospitalized with Acute Myocardial Infarction. A Randomized Trial

Application of intensive management of risk awareness combined with cardiac rehabilitation nursing in elderly patients with acute myocardial infarction and heart failure

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