The impact of readiness to discharge from hospital on adherence to treatment in patients after myocardial infarction

Kosobucka, Agata; Michalski, Piotr; Pietrzykowski, Łukasz; Kasprzak, Michał; Fabiszak, Tomasz; Felsmann, Mirosława; Kubica, Aldona

doi:10.5603/cj.a2020.0005

Cited by 30 publications

(33 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, we did not show that the level of knowledge of patients on the day of discharge affected compliance with therapeutic recommendations in the field of pharmacotherapy after 6 months of observation. On the other hand, another study analyzing the impact of readiness for discharge on adherence showed that an increase in the objective assessment of patients' knowledge (RHD-MIS subscale) affects a higher level of compliance [23].…”

Section: Discussionmentioning

confidence: 99%

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

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Self Cite

View full text Add to dashboard Cite

show abstract

“…Its elimination might largely improve the clinical and economical outcomes of treatment [ 8 , 16 ]. Recognizing the importance of this problem, our team have conducted a wide spectrum research in this field [ 6 , 17 , 18 , 19 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Therapy Discontinuation after Myocardial Infarction

Pietrzykowski

Kasprzak

Michalski

et al. 2020

JCM

Self Cite

View full text Add to dashboard Cite

The discontinuation of recommended therapy after myocardial infarction predisposes patients to serious thrombotic complications. The aim of this study was a comprehensive analysis of permanent as well as short- and long-term discontinuation of pharmacotherapy, taking into consideration the basic groups of medications and nonadherence determinants in a one-year follow-up in post-myocardial infarction (MI) patients. Material and methods: The study was a single center cohort clinical trial with a one-year follow-up including 225 patients (73.3% men, 26.7% women) aged 62.9 ± 11.9 years. In eight cases (3.6%), the follow-up duration was less than one year due to premature death. The following factors were analyzed: lack of post-discharge therapy initiation; short-term therapy discontinuation (<30 days); long-term therapy discontinuation (≥30 days); and permanent cessation of therapy. The analysis of therapy discontinuation was performed based on prescription filling data. Results: Occupational activity (Odds Ratio (OR) 5.15; 95% Confidence interval (CI) 1.42–18.65; p = 0.013) and prior MI (OR 5.02; 95% CI 1.45–16.89; p = 0.009) were found to be independent predictors of a lack of post-discharge therapy initiation with P2Y12 receptor inhibitors. We found no independent predictors of lack of post-discharge therapy initiation with other medications, whether analyzed separately or together. Age above 65 years (Hazard Ratio (HR)—1.59; 95% CI 1.15–2.19; p = 0.0049) and prior revascularization (HR—1.44; 95% CI 1.04–2.19; p = 0.0273) were identified as independent predictors of therapy discontinuation. Multilogistic regression analysis showed no independent predictors of the cessation of any of the medications as well as the permanent or temporary simultaneous discontinuation of all medications. Conclusions: The vast majority of post-MI patients discontinue, either temporarily or permanently, one of the essential medications within one year following myocardial infarction. The most likely medication class to be discontinued are statins. Older age and prior cardiac revascularization are independent determinants of therapy discontinuation.

show abstract

“…The presented data were collected as a part of the research project "Impact of educational intervention on adherence to therapeutic recommendations". Some results of this project have already been published [11][12][13][14].…”

Section: Methodsmentioning

confidence: 99%

Impact of readiness for discharge from the hospital on the implementation of the therapeutic plan

Kosobucka

Pietrzykowski

Michalski

et al. 2020

Medical Research Journal

Self Cite

View full text Add to dashboard Cite

The impact of readiness to discharge from hospital on adherence to treatment in patients after myocardial infarction

Cited by 30 publications

References 28 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

Therapy Discontinuation after Myocardial Infarction

Impact of readiness for discharge from the hospital on the implementation of the therapeutic plan

Contact Info

Product

Resources

About