Effects of transitional health management on adherence and prognosis in elderly patients with acute myocardial infarction in percutaneous coronary intervention: A cluster randomized controlled trial

Wu, Qing; Zhang, Dandan; Zhao, Qi; Liu, Lin; He, Zhisong; Chen, Yan; Huang, Hui; Hou, Yunyin; Yang, Xiaofang; Gu, Jie

doi:10.1371/journal.pone.0217535

Cited by 17 publications

(25 citation statements)

References 27 publications

(31 reference statements)

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“…A randomized clinical trial divided with 140 elders after acute myocardial infarctions in two groups (control and intervention), and found that the intervention group, which received telephone follow up about the treatment of the disease from health workers for 12 weeks after a hospital discharge related to the ischemic event, showed a better adherence to the drug therapy and to the healthy lifestyle, with lower rates of adverse effects and readmissions. All variables compared were statistically significant (27) .…”

Section: Discussionmentioning

confidence: 91%

The care offered by nurses to elders with coronary artery disease from the perspective of Transitions Theory

et al. 2021

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Objective: To analyze the planning and implementation of the care offered by nurses to elders with coronary disease during the hospital-house transition. Methods: Qualitative research that used the Transitions Theory as a theoretical reference. The participants were 12 nurses who work in a hospital that specializes in cardiology, in the city of Salvador-BA. A semistructured interview was carried out from January to February 2018, and the data was analyzed using the Content Analysis technique. Results: Transition care takes place on the day of discharge. The presence of the family was found to be a facilitator; low adherence, poor financial situations, the low educational levels inhibited its implementation. The rehospitalization is an indicator of the results of the transition of care. Final considerations: The planning and implementation of transition care is not effective. It must provide safety in the management of self-care in the home of elders with coronary disease and their families.

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Section: Discussionmentioning

confidence: 91%

The care offered by nurses to elders with coronary artery disease from the perspective of Transitions Theory

et al. 2021

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“…This result can be related to the fact that the patients did not consider it lack of adherence when they forget to take their medications at the prescribed times. Other studies have also shown that a large number of patients reported neglecting the medication schedule ( 8 , 10 , 20 ) .…”

Section: Discussionmentioning

confidence: 99%

“…Other studies also emphasize that the difficulty of physical access (due to distance or limited means of transportation) and the difficulties in accessing the medications also contribute to lack of adherence ( 8 , 17 ) . The individuals who have a health insurance tend to use the services more and, in turn, attend to medical appointments more often, thereby increasing the opportunity to access information that can support adherence ( 10 ) . One of the main benefits of easy access to the health care services is the possibility of therapeutic adjustments and monitoring ( 17 ) .…”

Section: Discussionmentioning

confidence: 99%

“…Another study found that 49.3% of the patients had low adherence to statins and antiplatelet agents or potential for such 30 days after hospital discharge for Acute Coronary Syndrome ( 8 ) . Lack of adherence to pharmacological treatment is a complicating factor for readmissions ( 10 ) due to decompensations. A meta-analysis including 10 studies with 106,002 patients demonstrated that adequate pharmacological adherence reduced the risk of global and cardiovascular mortality, in addition to hospitalization for cardiovascular disease and AMI ( 11 ) .…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of pharmacological adherence in patients with coronary artery disease and associated factors

Padilha

Santos

Lopes

et al. 2021

Rev. Latino-Am. Enfermagem

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Objective: to assess the prevalence of pharmacological adherence in patients with coronary artery disease and to identify factors associated with adherence. Method: a crosssectional, correlational study, including 198 patients with a previous diagnosis of coronary artery disease. Pharmacological adherence was assessed by the four-item Morisky Green test, and the factors that potentially interfere with adherence were considered independent variables. The association between the variables was determined by the Cox model, with a 5% significance level. Results: 43% of the patients adhered to the treatment. Fatigue and palpitation, never having consumed alcohol and being served by medical insurance were associated with adherence. Lack of adherence was associated with considering the treatment complex, consumption of alcohol and being served by the public health care system. In the multiple analysis, the patients with fatigue and palpitations had a prevalence of adherence around three times higher and alcohol consumption was associated with a 2.88 times greater chance of non-adherence. Conclusion: more than half of the patients were classified as non-adherent. Interventions can be directed to some factors associated with lack of adherence.

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“…Post-acute hospital-to-home healthcare programmes have been suggested to improve medication adherence and clinical indicators, and to reduce rates of adverse cardiovascular events and rehospitalisation [ 40 ]. The broader adherence measures of ASHRO predictive models developed for populations with prior hospitalisation for cardiovascular disease may reflect the healthcare provided in transitional care.…”

Section: Discussionmentioning

confidence: 99%

Development of a predictive model for integrated medical and long-term care resource consumption based on health behaviour: application of healthcare big data of patients with circulatory diseases

Takura

Goto

Honda³

2021

BMC Med

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Background Medical costs and the burden associated with cardiovascular disease are on the rise. Therefore, to improve the overall economy and quality assessment of the healthcare system, we developed a predictive model of integrated healthcare resource consumption (Adherence Score for Healthcare Resource Outcome, ASHRO) that incorporates patient health behaviours, and examined its association with clinical outcomes. Methods This study used information from a large-scale database on health insurance claims, long-term care insurance, and health check-ups. Participants comprised patients who received inpatient medical care for diseases of the circulatory system (ICD-10 codes I00-I99). The predictive model used broadly defined composite adherence as the explanatory variable and medical and long-term care costs as the objective variable. Predictive models used random forest learning (AI: artificial intelligence) to adjust for predictors, and multiple regression analysis to construct ASHRO scores. The ability of discrimination and calibration of the prediction model were evaluated using the area under the curve and the Hosmer-Lemeshow test. We compared the overall mortality of the two ASHRO 50% cut-off groups adjusted for clinical risk factors by propensity score matching over a 48-month follow-up period. Results Overall, 48,456 patients were discharged from the hospital with cardiovascular disease (mean age, 68.3 ± 9.9 years; male, 61.9%). The broad adherence score classification, adjusted as an index of the predictive model by machine learning, was an index of eight: secondary prevention, rehabilitation intensity, guidance, proportion of days covered, overlapping outpatient visits/clinical laboratory and physiological tests, medical attendance, and generic drug rate. Multiple regression analysis showed an overall coefficient of determination of 0.313 (p < 0.001). Logistic regression analysis with cut-off values of 50% and 25%/75% for medical and long-term care costs showed that the overall coefficient of determination was statistically significant (p < 0.001). The score of ASHRO was associated with the incidence of all deaths between the two 50% cut-off groups (2% vs. 7%; p < 0.001). Conclusions ASHRO accurately predicted future integrated healthcare resource consumption and was associated with clinical outcomes. It can be a valuable tool for evaluating the economic usefulness of individual adherence behaviours and optimising clinical outcomes.

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Effects of transitional health management on adherence and prognosis in elderly patients with acute myocardial infarction in percutaneous coronary intervention: A cluster randomized controlled trial

Cited by 17 publications

References 27 publications

The care offered by nurses to elders with coronary artery disease from the perspective of Transitions Theory

The care offered by nurses to elders with coronary artery disease from the perspective of Transitions Theory

Prevalence of pharmacological adherence in patients with coronary artery disease and associated factors

Development of a predictive model for integrated medical and long-term care resource consumption based on health behaviour: application of healthcare big data of patients with circulatory diseases

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