Individualized Discharge Education in High-Risk Myocardial Infarction Patients

Официальное название

The Effect of Individualized Discharge Education on Readmission Rates in a High-Risk Population According to the LACE Index After Myocardial Infarction

Обзор

The purpose of this clinical study is to evaluate whether individualized discharge education is effective in treating patients identified as high-risk based on the LACE index after a myocardial infarction. Additionally, information will be gathered regarding the safety and outcomes of this education. The key questions the study aims to answer are: Does individualized discharge education reduce hospital readmission rates for patients identified as high-risk after a myocardial infarction? Does this education improve patients' treatment adherence, self-care levels, and quality of life? Researchers will compare the effectiveness of individualized discharge education against routine care. Participants will:Receive individualized discharge education prior to discharge if they meet the high-risk criteria, and receive a comprehensive educational brochure. Be followed up via telephone three days a week while at home to monitor their care practices and hospital visits. Participate in follow-up assessments at the 1st month (Follow-up 1) and 3rd month (Follow-up 3) to complete the Coronary Heart Disease Self-Care Inventory and the HeartQoL scale.

Подробное описание

This study is a controlled research project examining the impact of individualized discharge education on clinical outcomes in patients identified as "high-risk" following a myocardial infarction (MI) using the LACE index. The study aims to determine the role of patient education and follow-up during the post-cardiovascular event care process in reducing hospital readmission rates. The fundamental interventions and processes to be carried out within the scope of the research are as follows:Risk Classification: Prior to discharge, patients treated in the cardiology clinic will be assessed using the LACE index, which includes length of hospital stay, acuity of admission, comorbidities, and emergency department visits within the previous 6 months. Patients with a LACE score of 10 or higher will be classified as "high-risk" and included in the study. Educational Intervention: The intervention group will receive a structured discharge education program tailored to the patients' clinical characteristics, educational levels, and risk profiles. During the education process, a comprehensive brochure containing all relevant information will be provided. The control group will continue to receive the hospital's standard routine care. Monitoring and Follow-up: Patients will be followed for 3 months during the post-discharge period. Patients in the intervention group will be contacted by telephone 3 days a week while at home to monitor their self-care practices and hospital visits. Assessment Points: Research data will be collected before discharge (Follow-up 0), at the 1st month post-discharge (Follow-up 1), and at the 3rd month (Follow-up 3). During this process, patients' readmission statuses will be recorded, and clinical changes will be compared using the Percutaneous Coronary Intervention Information Needs Scale (NCPI-10), the Self-Care of Coronary Heart Disease Inventory (SC-CHDI), and the HeartQoL scale. Data Analysis: The collected data will be subjected to statistical analysis using SPSS 29 software to evidence-based demonstrate the effectiveness of individualized nursing education in improving patient outcomes.

Вмешательства

• Поведенческое Individualized discharge education
  Education will cover the following topics: Disease Knowledge and Process Management: Definition of myocardial infarction, long-term management of the disease, risk of recurrence, and recognition of complication symptoms. Adherence to Medication Therapy: Regular use of medications, their effects, and methods of administration. Management of Comorbidities: Monitoring and managing existing co-occurring conditions as part of the overall care plan. Self-Care and Lifestyle Modifications: Nutritio

Первичные конечные точки

• LACE index [Срок оценки: Day 1]
• Percutaneous Coronary Intervention Information Needs Scale (NCPI-10) [Срок оценки: Day 1]
• The Self-Care of Coronary Heart Disease Inventory (SC-CHDI) [Срок оценки: Day 1]
• Heart Quality of Life (HeartQoL) Scale [Срок оценки: Day 1]
• Personal Information Form [Срок оценки: Day 1]

Вторичные конечные точки (2)

• The Self-Care of Coronary Heart Disease Inventory (SC-CHDI) [Срок оценки: Day 1, first month and third month]
• Heart Quality of Life (HeartQoL) Scale: The Heart Quality of Life (HeartQoL) Scale [Срок оценки: Day 1, first month and third month]

Критерии участия

Критерии включения

• Being over 18 years of age,
• Not having a cognitive disorder,
• Not having a history of psychiatric disorders,
• Being open to communication,
• Not having hearing, visual or speech impairments,
• Having a LACE index score of 10 or higher,
• Being willing to participate in the research.

Критерии исключения

• Refusal to participate in the study
• Having a LACE index score below 10
• Not having a cognitive impairment,

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Двойное слепое

Основная цель

Поддерживающая терапия

Центры проведения

Turkey (Türkiye) · 1 центр

• Adıyaman University — Adıyaman

Публикации

• Oldridge N, Hofer S, McGee H, Conroy R, Doyle F, Saner H; (for the HeartQoL Project Investigators). The HeartQoL: part II. Validation of a new core health-related quality of life questionnaire for patients with ischemic heart disease. Eur J Prev Cardiol. 2014 Jan;21(1):98-106. doi: 10.1177/2047487312450545. Epub 2012 Jul 20. PMID 22822180
• Vaughan Dickson V, Lee CS, Yehle KS, Mola A, Faulkner KM, Riegel B. Psychometric Testing of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI). Res Nurs Health. 2017 Feb;40(1):15-22. doi: 10.1002/nur.21755. Epub 2016 Sep 30. PMID 27686630
• Bayrak B, Oguz S. Validity and reliability of the Turkish version of the Self-Care of Coronary Heart Disease Inventory. Int J Nurs Pract. 2021 Feb;27(1):e12847. doi: 10.1111/ijn.12847. Epub 2020 May 5. PMID 32369875
• Tsoulou V, Vasilopoulos G, Kapadohos T, Panoutsopoulos G, Kalogianni A, Toulia G, Koutelekos I, Gerogianni G, Polikandrioti M. Information Needs in Percutaneous Coronary Artery Intervention: Validation and Reliability Analysis of NPCI-10 Item Scale. Cureus. 2021 Jan 15;13(1):e12718. doi: 10.7759/cureus.12718. PMID 33489636
• Lizcano-Alvarez A, Carretero-Julian L, Talavera-Saez A, Cristobal-Zarate B, Cid-Exposito MG, Alameda-Cuesta A; REccAP Group (Red de Enfermeria de Cuidados Cardiovasculares en Atencion Primaria). Intensive nurse-led follow-up in primary care to improve self-management and compliance behaviour after myocardial infarction. Nurs Open. 2023 Aug;10(8):5211-5224. doi: 10.1002/nop2.1758. Epub 2023 Apr 21. PMID 37084014
• Yazdan-Ashoori P, Lee SF, Ibrahim Q, Van Spall HG. Utility of the LACE index at the bedside in predicting 30-day readmission or death in patients hospitalized with heart failure. Am Heart J. 2016 Sep;179:51-8. doi: 10.1016/j.ahj.2016.06.007. Epub 2016 Jun 18. PMID 27595679
• Duğan, Ö., & Bektaş, H. (2020). Koroner arter hastalarında Kalp Yaşam Kalitesi Ölçeği'nin Türkçeye uyarlama çalışması. Turkish Journal of Cardiovascular Nursing, 11(25), 71-81. https://doi.org/10.5543/khd.2020.38278
• Rajaguru V, Han W, Kim TH, Shin J, Lee SG. LACE Index to Predict the High Risk of 30-Day Readmission: A Systematic Review and Meta-Analysis. J Pers Med. 2022 Mar 30;12(4):545. doi: 10.3390/jpm12040545. PMID 35455661

Идентификаторы

NCT: NCT07701109 · 2026/4-21

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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