Intensive patient education prepares care-seeking attitudes for acute myocardial infarction

Intensive patient education prepares care-seeking attitudes for acute myocardial infarction

Heart attack survivors who participated in a psychoeducational intervention reported changes in attitude and beliefs about seeking care if they experienced acute myocardial infarction (MI) symptoms again, a randomized trial from Hong Kong showed.

Patients randomized to the intervention group, which consisted of five face-to-face sessions led by nurses in which they discussed and interacted with educational videos in small groups, reported more positive changes in their attitudes and beliefs toward care-seeking on the Index of Response of the Acute Coronary Syndrome Questionnaire (Chinese version) at 3 and 12 months compared with controls who participated in four weekly nurse-led educational conferences on acute MI and care-seeking, reported Polly Li, PhD, of the University of Hong Kong School of Nursing, and colleagues.

Of note, knowledge about symptoms of acute myocardial infarction was not significantly different at 3 months and 12 months, they noted in Open JAMA Network.

However, the hope is that more positive care-seeking attitudes will translate into more rapid treatment and revascularization, and ultimately, further improvements in clinical outcomes after heart attacks.

“Longer-term follow-up to assess actual care-seeking behavior and clinical outcomes in patients with acute MI is warranted to determine the sustained effects of this intervention,” Li and colleagues acknowledge.

They noted that prehospital delays in acute myocardial infarction have persisted for years, while significant improvements have been achieved in reducing door-to-treatment time. media campaigns Y counseling interventions they have generally failed to reduce prehospital delays.

Previous studies have found women in particular be slower to seek medical attention for heart attacks.

In addition to that, the COVID-19 pandemic it has been associated with longer ischemia times and more late-presenting patients with ST-segment elevation myocardial infarction.

In this study, the narrative-based psychoeducational intervention included teaching symptom recognition skills, managing emotional responses at symptom onset, overcoming perceived barriers, and mastering the decision-making process.

The new intervention was tested from 2018 to 2021 in a trial that included 608 heart attack survivors recruited from four Hong Kong hospitals. The median age was 67 years, 77% were male, and all were of Chinese ethnicity.

Participants were randomly assigned to psychoeducational intervention or didactic teaching. The two groups were well balanced demographically, except that the intervention group had proportionally more women.

Overall adherence was 91.0% for the intervention group and 84.2% for the control group.

“Unlike previous studies targeting the general public or others living in the community, we targeted those patients who had had a prior episode of acute myocardial infarction to prepare them to respond to a recurrent attack. These are likely patients perceive the intervention to be more relevant to and thus be more receptive to the intervention,” Li and colleagues noted.

Whether such an intervention is feasible in a busy clinical setting remains to be seen; a format could be found and tested online, the team suggested.

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    nicole lou She is a reporter for MedPage Today, where she covers cardiology news and other advances in medicine. To follow

Disclosures

The study was funded by a grant from the Hong Kong government.

Li and his colleagues made no disclosures.

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