Clark Robyn A, Foote Jonathon, Versace Vincent L, Brown Alex, Daniel Mark, Coffee Neil T, Marin Tania S, Kourbelis Constance, Arstall Margaret, Ganesan Anand, Maddison Ralph, Kelly Janet, Barry Tracey, Keech Wendy, Nicholls Stephen J
College of Nursing and Health Sciences, Flinders University, Adelaide 5001, Australia.
Deakin University, Warnambool, Victoria 3280, Australia.
Med Sci (Basel). 2019 Apr 19;7(4):61. doi: 10.3390/medsci7040061.
The aim of this study was to investigate the impact of bedside discharge education on activity levels and healthcare utilization for patients with acute coronary syndrome (ACS) in the first 30 days post-discharge. Knowledge recall and objective activity and location data were collected by global positioning systems (GPS). Participants were asked to carry the tracking applications (apps) for 30⁻90 days. Eighteen participants were recruited (6 metropolitan 12 rural) 61% ST elevation myocardial infarction (STEMI), mean age 55 years, 83% male. Recall of discharge education included knowledge of diagnosis (recall = 100%), procedures (e.g., angiogram = 40%), and comorbidities (e.g., hypertension = 60%, diabetes = 100%). In the first 30 days post-discharge, median steps per day was 2506 (standard deviation (SD) ± 369) steps (one participant completed 10,000 steps), 62% visited a general practitioner (GP) 16% attended cardiac rehabilitation, 16% visited a cardiologist, 72% a pharmacist, 27% visited the emergency department for cardiac event, and 61% a pathology service (blood tests). Adherence to using the activity tracking apps was 87%. Managing Big Data from the GPS and physical activity tracking apps was a challenge with over 300,000 lines of raw data cleaned to 90,000 data points for analysis. This study was an example of the application of objective data from the real world to help understand post-ACS discharge patient activity. Rates of access to services in the first 30 days continue to be of concern.
本研究的目的是调查床边出院教育对急性冠状动脉综合征(ACS)患者出院后前30天活动水平和医疗保健利用情况的影响。通过全球定位系统(GPS)收集知识回忆以及客观活动和位置数据。参与者被要求携带追踪应用程序30至90天。招募了18名参与者(6名来自大城市,12名来自农村),61%为ST段抬高型心肌梗死(STEMI),平均年龄55岁,83%为男性。出院教育的知识回忆包括对诊断的了解(回忆率 = 100%)、手术(如血管造影 = 40%)和合并症(如高血压 = 60%,糖尿病 = 100%)。在出院后的前30天,每天的步数中位数为2506步(标准差(SD)±369步)(一名参与者完成了10000步),62%的人拜访了全科医生(GP),16%的人参加了心脏康复,16%的人拜访了心脏病专家,72%的人拜访了药剂师,27%的人因心脏事件前往急诊科,61%的人接受了病理检查(血液检查)。使用活动追踪应用程序的依从率为87%。管理来自GPS和身体活动追踪应用程序的大数据是一项挑战,超过30万行原始数据被清理为90000个数据点用于分析。本研究是一个应用来自现实世界的客观数据来帮助了解ACS出院后患者活动情况的例子。出院后前30天的服务获取率仍然令人担忧。