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Vol 5, No 4 (2020)
Original article
Published online: 2020-12-31
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Impact of readiness for discharge from the hospital on the implementation of the therapeutic plan

Agata Kosobucka1, Łukasz Pietrzykowski1, Piotr Michalski1, Michał Kasprzak2, Michał Siedlaczek1, Aldona Kubica1
·
Medical Research Journal 2020;5(4):256-264.
Affiliations
  1. Department of Health Promotion, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
  2. Department of Cardiology an Internal Medicine, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Poland

open access

Vol 5, No 4 (2020)
ORIGINAL ARTICLES
Published online: 2020-12-31

Abstract

Introduction. Adherence to therapeutic recommendations regarding pharmacotherapy and lifestyle modification reduces the risk of complications in patients after myocardial infarction. The assessment of readiness for discharge allows to get knowledge about patient’s preparation for functioning at home. The aim of the study is to assess the relationship between the readiness for discharge of patients after myocardial infarction and adherence to pharmacotherapy based of the analysis of prescription filling.

Material and methods.
The study is a single-center, prospective, observational cohort clinical trial with a one-year follow-up period. The study population include 225 patients (26.7% women and 73.3% men) aged 30–91years (62.9 ± 11.9). The RHD-MIS (Readiness for Hospital Discharge after Myocardial Infarction Scale) was used to assess the readiness for discharge. Adherence to medication has been studied in relation to ACE inhibitors, P2Y12 receptor inhibitors and statins.

Results.
Patients with a high overall RHD MIS score compared to those with an average result were more likely to have any breaks in therapy, p = 0.01 (breaks < 30 days, p = 0.03 and breaks ≥ 30 days, p = 0.005) for either drug. Patients declaring that their disease is not serious have significantly lower adherence to P2Y12 receptor inhibitor (28 ± 27% vs 72 ± 38%, p = 0.047) and statins (36 ± 41% vs 76 ± 33% p = 0.024) in the 1st quarter after discharge and to statins (23 ± 18% vs 65 ± 32% p = 0.014) during whole one-year follow-up.

Conclusion.
The readiness for discharge from the hospital assessed with the RHD-MIS does not clearly affect the implementation of the therapeutic plan in the long-term follow-up in patients after myocardial infarction. Data suggesting a negative impact of some aspects of readiness for discharge on adherence to treatment require further, in-depth research.

Abstract

Introduction. Adherence to therapeutic recommendations regarding pharmacotherapy and lifestyle modification reduces the risk of complications in patients after myocardial infarction. The assessment of readiness for discharge allows to get knowledge about patient’s preparation for functioning at home. The aim of the study is to assess the relationship between the readiness for discharge of patients after myocardial infarction and adherence to pharmacotherapy based of the analysis of prescription filling.

Material and methods.
The study is a single-center, prospective, observational cohort clinical trial with a one-year follow-up period. The study population include 225 patients (26.7% women and 73.3% men) aged 30–91years (62.9 ± 11.9). The RHD-MIS (Readiness for Hospital Discharge after Myocardial Infarction Scale) was used to assess the readiness for discharge. Adherence to medication has been studied in relation to ACE inhibitors, P2Y12 receptor inhibitors and statins.

Results.
Patients with a high overall RHD MIS score compared to those with an average result were more likely to have any breaks in therapy, p = 0.01 (breaks < 30 days, p = 0.03 and breaks ≥ 30 days, p = 0.005) for either drug. Patients declaring that their disease is not serious have significantly lower adherence to P2Y12 receptor inhibitor (28 ± 27% vs 72 ± 38%, p = 0.047) and statins (36 ± 41% vs 76 ± 33% p = 0.024) in the 1st quarter after discharge and to statins (23 ± 18% vs 65 ± 32% p = 0.014) during whole one-year follow-up.

Conclusion.
The readiness for discharge from the hospital assessed with the RHD-MIS does not clearly affect the implementation of the therapeutic plan in the long-term follow-up in patients after myocardial infarction. Data suggesting a negative impact of some aspects of readiness for discharge on adherence to treatment require further, in-depth research.

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Keywords

readiness for discharge from the hospital, myocardial infarction, adherence to treatment

About this article
Title

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

Journal

Medical Research Journal

Issue

Vol 5, No 4 (2020)

Article type

Original article

Pages

256-264

Published online

2020-12-31

Page views

634

Article views/downloads

668

DOI

10.5603/MRJ.a2020.0047

Bibliographic record

Medical Research Journal 2020;5(4):256-264.

Keywords

readiness for discharge from the hospital
myocardial infarction
adherence to treatment

Authors

Agata Kosobucka
Łukasz Pietrzykowski
Piotr Michalski
Michał Kasprzak
Michał Siedlaczek
Aldona Kubica

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