Reinforcement of patient education improved physicians’ adherence to guideline-recommended medical therapy after acute coronary syndrome
Journal
PLoS ONE
Journal Volume
14
Journal Issue
6
Pages
e0217444
Date Issued
2019
Author(s)
Lee M.-H.
Su F.-Y.
Yeh T.-S.
Cheng L.-Y.
Abstract
Background Prescription of guideline-recommended medicines after acute coronary syndrome (ACS) has been suboptimal. Tools for improving the use of medications have been developed, but they mainly targeted physicians. Objective We evaluated the effects of reinforcement of patient and family education on the usage of guideline-recommended secondary prevention medications. Methods This was a retrospective analysis of a prospectively collected registry of patients with ACS who were admitted to a regional teaching hospital in Taiwan between February 2015 and April 2017. The control group included 76 patients discharged before implementing the electronic-based patient and family education (PFE) system. The intervention group included 206 patients discharged after implementation. The primary outcome was the prescription rate of all four guideline-recommended drugs. Predictors of adherence were also evaluated. Results The study cohort included 282 ACS patients (188 men and 94 women) with a mean age of 68.5 years (standard deviation, 14.2). The intervention group patients were younger, had more family history of premature cardiovascular disease, more dyslipidemia, and underwent more reperfusion therapy. The intervention group was prescribed more guideline-recommended drugs than the control group: dual antiplatelet agents, 79.61% vs. 47.37% (p<0.001); statins, 74.76% vs. 34.21% (p<0.001); beta-blockers, 81.07% vs. 46.05% (p<0.001); angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, 62.62% vs. 38.16% (p<0.001); and a combination of all four medications, 39.32% vs. 14.47% (p<0.001). After adjusting baseline variables, the PFE system remained a significant contributor to adherence to these drugs use (P = 0.02). Conclusions Reinforcement of patient education was associated with significant improvements in physicians’ adherence to guideline-recommended medical therapy after acute coronary syndrome. ? 2019 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
SDGs
Other Subjects
angiotensin receptor antagonist; antithrombocytic agent; beta adrenergic receptor blocking agent; dipeptidyl carboxypeptidase inhibitor; hydroxymethylglutaryl coenzyme A reductase inhibitor; acute coronary syndrome; aged; Article; cohort analysis; controlled study; coronary artery bypass graft; demography; doctor patient relationship; drug use; dyslipidemia; female; hospital admission; hospital discharge; human; intervention study; major clinical study; male; medication compliance; patient education; percutaneous coronary intervention; practice guideline; prescription; prospective study; retrospective study; teaching hospital
Publisher
Public Library of Science
Type
journal article