Pietrzykowski Łukasz, Kasprzak Michał, Michalski Piotr, Kosobucka Agata, Fabiszak Tomasz, Kubica Aldona
Department of Health Promotion, Collegium Medicum, Nicolaus Copernicus University, M. Curie Skłodowskiej 9 St., 85-094 Bydgoszcz, Poland.
Department of Cardiology and Internal Diseases, Collegium Medicum, Nicolaus Copernicus University, M. Curie Skłodowskiej 9 St., 85-094 Bydgoszcz, Poland.
Patient Educ Couns. 2022 Feb;105(2):426-431. doi: 10.1016/j.pec.2021.05.030. Epub 2021 May 23.
In-hospital patient education is one of the elements affecting patient adherence to treatment regimen after myocardial infarction (MI). Its effectiveness is determined by educator and patient-dependent factors. Previous studies did not identify patient expectations as an independent determinant of successful education. The aim of this study was to assess whether patient knowledge and expectations affect adherence to treatment regimen in a 1-year follow-up.
This was a single-center, cohort study with a 1-year follow-up. Patient knowledge and expectations were evaluated using the Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD-MIS scale). Medication adherence (including angiotensin converting enzyme inhibitors (ACEI), P2Y12 receptor inhibitors and statins) was verified based on prescription refill data extracted from The National Health Fund database.
The study included 225 patients aged 30-91 years (mean age 62.9 ± 11.9 years). In the 4th quarter of follow-up, patients with the highest expectations had lower adherence regarding ACEI (p = 0.01), P2Y12 receptor inhibitors (p = 0.03) and the combination of all three analysed medications (p = 0.003).
The initial results suggest presence of a relationship between patient expectations and long-term adherence to treatment.
Post-MI patient education directed at fulfilling or modification of patient expectations could possibly improve execution of treatment regimen.
住院患者教育是影响心肌梗死（MI）后患者治疗方案依从性的因素之一。其有效性取决于教育者和患者相关因素。既往研究未将患者期望确定为成功教育的独立决定因素。本研究的目的是评估在1年随访中患者的知识和期望是否会影响治疗方案的依从性。
这是一项单中心队列研究，随访1年。使用心肌梗死后出院准备量表（RHD-MIS量表）评估患者的知识和期望。根据从国家卫生基金数据库中提取的处方 refill 数据核实药物依从性（包括血管紧张素转换酶抑制剂（ACEI）、P2Y12受体抑制剂和他汀类药物）。
该研究纳入了225例年龄在30-91岁之间的患者（平均年龄62.9±11.9岁）。在随访的第4季度，期望最高的患者在ACEI（p=0.01）、P2Y12受体抑制剂（p=0.03）以及所有三种分析药物联合使用方面的依从性较低（p=0.003）。
初步结果表明患者期望与长期治疗依从性之间存在关联。
针对满足或调整患者期望的心肌梗死后患者教育可能会改善治疗方案的执行情况。
