Department of Pharmacy Practice, MCPHS University , Boston, MA, USA.
Well Life Medical , Peabody, MA, USA.
Postgrad Med. 2020 Jun;132(5):426-432. doi: 10.1080/00325481.2020.1740512. Epub 2020 Mar 24.
Despite therapeutic advances, patients with acute coronary syndrome (ACS) are at an increased long-term risk of recurrent cardiovascular events. This risk continues to rise as the number of associated comorbidities, often observed in patients presenting with ACS, increases. Such a level of clinical complexity can lead to gaps in care and subsequently worse outcomes. Guidelines recommend providing an evidence-based post-discharge plan to prevent readmission and recurrent ACS, including cardiac rehabilitation, medication, patient/caregiver education, and ongoing follow-up. A patient-centric multidisciplinary approach is critical for the effective management of the transition of care from acute care in the hospital setting to the outpatient care setting in patients with ACS. Ongoing communication between in-hospital and outpatient healthcare providers ensures that the transition is smooth. Primary care providers and pharmacists have a pivotal role to play in the effective management of transitions of care in patients with ACS. Guideline recommendations regarding the post-discharge care of patients with ACS and the role of the primary care provider and the pharmacist in the management of transitions of care will be reviewed.
尽管治疗有所进展,但急性冠状动脉综合征 (ACS) 患者的长期心血管事件复发风险仍然较高。随着 ACS 患者中经常观察到的相关合并症数量的增加,这种风险持续上升。如此高的临床复杂性可能导致护理差距,并最终导致更差的结果。指南建议提供基于证据的出院后计划,以预防再入院和复发性 ACS,包括心脏康复、药物治疗、患者/护理人员教育和持续随访。以患者为中心的多学科方法对于有效管理 ACS 患者从医院急性护理到门诊护理的过渡至关重要。医院内和门诊医疗保健提供者之间的持续沟通可确保过渡顺利进行。初级保健提供者和药剂师在 ACS 患者的护理过渡管理中发挥着关键作用。将回顾 ACS 患者出院后护理以及初级保健提供者和药剂师在护理过渡管理中的作用的指南建议。