Impacts of Omaha System-Based Continuing Care on the Medication Compliance, Quality of Life, and Prognosis of Coronary Heart Disease Patients After PCI

Yin, Sijuan; Ou, Yangyi; Ting, E

doi:10.21470/1678-9741-2021-0222

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Brazilian Journal of Cardiovascular Surgery

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ORIGINAL ARTICLE • Braz. J. Cardiovasc. Surg. 37 (04) • 2022 • https://doi.org/10.21470/1678-9741-2021-0222 copy

Impacts of Omaha System-Based Continuing Care on the Medication Compliance, Quality of Life, and Prognosis of Coronary Heart Disease Patients After PCI

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

The objective of this study is to explore the impacts of Omaha System-based continuing care on medication compliance, quality of life (QOL), and prognosis of coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI).

Methods:

A total of 100 CHD patients who were hospitalized and received PCI were selected and divided into the control group and the observation group, 50 patients per group, according to a random number table method. The control group was given routine care, while the observation group was applied Omaha System-based continuing care on the basis of the control group.

Results:

Follow-up demonstrated that the Morisky-Green score of the observation group was significantly higher than that of the control group (P<0.001), indicating that the medication compliance of the observation group was significantly better than that of the control group (P<0.001). The short form-36 (SF-36) scores were notably higher after nursing compared with on admission; SF-36 scores of the observation group were significantly increased than those of the control group (P<0.001). The incidence of major adverse cardiac event (MACE) in the observation group was significantly lower than in the control group (P<0.001). The nursing satisfaction of the observation group was considerably higher than that of the control group (P<0.01).

Conclusion:

Omaha System-based continuing care could improve the medication compliance and QOL, reduce the incidence of MACE, and benefit the prognosis of CHD patients after PCI.

Keywords:
Percutaneous Coronary Intervention; Medication Adherence; Continuing Care; Coronary Heart Disease; Personal Satisfaction; Quality of Life.

Abbreviations, Acronyms & Symbols
BMI	= Body mass index
CHD	= Coronary heart disease
ESC	= European Society of Cardiology
MACE	= Major adverse cardiac event
PCI	= Percutaneous coronary intervention
QOL	= Quality of life
SF-36	= Short form-36

Category	Observation group	Control group	χ²2 Collet JP, Roffi M, Byrne RA, Costa F, Valgimigli M; Task Force for the Management of Dual Antiplatelet Therapy in Coronary Artery Disease of the European Society of Cardiology (ESC), et al. Case-based implementation of the 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease. Eur Heart J. 2018;39(3):e1-e33. doi:10.1093/eurheartj/ehx503. https://doi.org/10.1093/eurheartj/ehx503... test	P-value
Case (n)	50	50
Age (years)	67.1±7.8	69.5±7.5	0.853	0.40
Gender (male)	24	26	0.185	0.67
BMI (kg/m²2 Collet JP, Roffi M, Byrne RA, Costa F, Valgimigli M; Task Force for the Management of Dual Antiplatelet Therapy in Coronary Artery Disease of the European Society of Cardiology (ESC), et al. Case-based implementation of the 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease. Eur Heart J. 2018;39(3):e1-e33. doi:10.1093/eurheartj/ehx503. https://doi.org/10.1093/eurheartj/ehx503... )	24.74±2.98	24.12±3.01	1.043	0.30
Smoking	38	40	0.218	0.64
Drinking	35	33	0.182	0.67
Hypertension	28	29	0.182	0.67
Diabetes	25	23	0.501	0.48
Hypercholesterolemia	29	27	0.481	0.49
Cerebrovascular diseases	28	30	0.741	0.39
Education level			0.745	0.86
College	10	10
High school	22	20
Junior middle school	12	15
Primary school and below	6	5
CHD classification			0.863	0.94
Unstable angina	19	20
Stable angina	14	11
Acute myocardial infarction	10	9
Ischemic cardiomyopathy	6	8
Others	1	2
Cardiac function on admission			0.249	0.97
I	9	10
II	16	16
III	20	18
IV	5	6
PCI types			0.764	0.59
Percutaneous transluminal coronary angioplasty	14	11
Coronary stent implantation	32	35
Coronary thrombus aspiration	1	2
Others	3	2

Group	Case (n)	Morisky-Green score	Medication compliance (n, %)
Observation group	50	3.56±0.32	46 (92%)
Control group	50	2.28±0.44	24 (48%)
χ²2 Collet JP, Roffi M, Byrne RA, Costa F, Valgimigli M; Task Force for the Management of Dual Antiplatelet Therapy in Coronary Artery Disease of the European Society of Cardiology (ESC), et al. Case-based implementation of the 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease. Eur Heart J. 2018;39(3):e1-e33. doi:10.1093/eurheartj/ehx503. https://doi.org/10.1093/eurheartj/ehx503... test		16.642	19.238
P-value		< 0.001	< 0.001

Group	Observation group (n=50)		Control group (n=50)
Time	On admission	9-month follow-up	On admission	9-month follow-up
Physical function	52.44±2.84	61.24±2.48^*	54.52±2.82	80.72±2.56^***###
Social function	50.68±4.51	58.62±4.38^*	49.94±4.71	82.79±4.63^***###
Emotion	61.32±2.61	69.28±2.54^*	60.29±2.57	79.49±2.63^***###
Vitality	44.67±4.52	52.77±4.83^*	43.76±4.34	81.62±4.23^***###
Overall health	65.28±4.82	70.52±4.54^*	64.47±4.78	85.19±4.73^***###

Group	Observation group	Control group	P-value
Case (n)	50	50
Unstable angina	6	16	0.03
Non-fatal myocardial infarction	1	5	< 0.001
In-stent restenosis	1	5	< 0.001
Sudden cardiac death	0	2	0.50
Total	8	28	< 0.001

Group	Observation group	Control group	P-value
Case (n)	50	50
Very satisfied	42	22	< 0.001
Generally satisfied	6	15	0.03
Unsatisfied	2	13	< 0.01
Overall satisfaction	48 (96%)	37 (74%)	< 0.01

Authors’ Roles & Responsibilities
SY	Substantial contributions to the concept and design of the work; revising the work critically for important intellectual content; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; final approval of the version to be published
YO	Substantial contributions to the acquisition, analysis and interpretation of data for the work; final approval of the version to be published
TE	Substantial contributions to the analysis of data for the work; drafting the work and revising it critically; final approval of the version to be published

Sociedade Brasileira de Cirurgia Cardiovascular Rua Afonso Celso, 1178 Vila Mariana, CEP: 04119-061 - São Paulo/SP Brazil, Tel +55 (11) 3849-0341, Tel +55 (11) 5096-0079 - São Paulo - SP - Brazil
E-mail: bjcvs@sbccv.org.br

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[1] *
Co-first authors, contributed equally to this work.