Homem Filipa, Reveles Anaísa, Amaral António, Coutinho Verónica, Gonçalves Lino
ULS Coimbra, Cardiologia CHUC Coimbra Portugal.
UICISA:E/ESEnfC Coimbra University Coimbra Portugal.
Health Care Sci. 2024 Oct 13;3(5):312-328. doi: 10.1002/hcs2.116. eCollection 2024 Oct.
Cardiovascular disease remains the leading cause of morbidity and mortality, posing a significant challenge to healthcare systems worldwide. Transitional care interventions, which ensure coordination and continuity of care as patients move between different levels of healthcare, have been shown to reduce unnecessary healthcare utilization and improve patient outcomes. While much attention has been given to transitional care in heart failure, this review aims to map the interventions implemented for patients following an acute myocardial infarction (AMI). A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology, with literature searches performed in the Cochrane, CINAHL, MEDLINE, JBI, and SciELO databases, focusing on publications from 2013 onwards in both Portuguese and English. Seventy-five studies were included, with most combining multiple interventions that contributed to improved cardiovascular health outcomes, including increased adherence to healthy lifestyle behaviors, enhanced medication compliance, and better healthcare self-management. These interventions were effective in reducing cardiovascular-related Emergency Department visits, unplanned 30-day readmissions, and mortality following a first-time myocardial infarction. Key strategies identified included discharge planning, digital health solutions, outpatient care, and healthcare coordination. The findings of this review underscore the need for developing methodologies that enhance the transition of care from hospital to primary care following an AMI. There is an urgent need to design and implement new healthcare programs that integrate discharge interventions, digital health, outpatient care, and healthcare coordination to ensure continuity of care and optimize patient outcomes post-discharge.
心血管疾病仍然是发病和死亡的主要原因，给全球医疗系统带来了重大挑战。过渡性护理干预措施可确保患者在不同医疗级别之间转移时护理的协调和连续性，已被证明可以减少不必要的医疗利用并改善患者预后。虽然心力衰竭的过渡性护理受到了很多关注，但本综述旨在梳理针对急性心肌梗死（AMI）患者实施的干预措施。按照乔安娜·布里格斯研究所（JBI）的方法进行了一项范围综述，在Cochrane、CINAHL、MEDLINE、JBI和SciELO数据库中进行文献检索，重点关注2013年以后以葡萄牙语和英语发表的文献。纳入了75项研究，大多数研究结合了多种有助于改善心血管健康结果的干预措施，包括增加对健康生活方式行为的依从性、提高药物依从性以及更好的医疗自我管理。这些干预措施有效地减少了与心血管相关的急诊科就诊、计划外30天再入院以及首次心肌梗死后的死亡率。确定的关键策略包括出院计划、数字健康解决方案、门诊护理和医疗协调。本综述的结果强调了开发方法以加强AMI后从医院到初级护理的护理过渡的必要性。迫切需要设计和实施新的医疗计划，整合出院干预措施、数字健康、门诊护理和医疗协调，以确保护理的连续性并优化出院后患者的预后。
