The impact of knowledge and effectiveness of educational intervention on readiness for hospital discharge and adherence to therapeutic recommendations in patients with acute coronary syndrome

Abstract

Introduction: ESC guidelines emphasize the importance of educating patients after acute coronary syndromes aimed at familiarizing the patient with the essence of the disease, the principles of self-control and self-care as well as actions enhancing health maintenance. Aim: The aim of the study was to assess the impact of knowledge and effectiveness of educational intervention on readiness for discharge from the hospital and compliance with therapeutic recommendations six months after discharge. Material and methods: The study group consisted of 218 patients (28.9% women and 71.1% men) aged 31 to 90 years (63.0 ± 11.24) treated with coronary angioplasty for myocardial infarction. The effectiveness of educational intervention was assessed by comparing patients’ knowledge on the day of admission (1KE) and discharge from the hospital (2KE). Knowledge was assessed in 3 aspects: knowledge of symptoms, knowledge of the disease, and knowledge of prevention. Education was provided between 1KE and 2KE based on the brochure entitled “Myocardial Infarction”. The level of knowledge on the day of discharge and the increase in knowledge obtained after education (ΔKE) were referred to the level of Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD-MIS) and to the level of adherence in chronic diseases scale (ACDS). Results: As a result of the education carried out between 1KE and 2KE, a significant increase in knowledge was obtained (p < 0.05). There was no correlation between ΔKE and RHD-MIS. However, it was shown that a higher level of knowledge at discharge (2KE) was associated with a higher RHD-MIS result (R = 0.17; p = 0.01). The highest impact on the RHD-MIS result was due to the level of knowledge of disease symptoms in 2KE: 75.5 ± 19.5%, 76.4 ± 21.1%, 85.8 ± 16.4% for low, medium and high RHD-MIS results (p = 0.002) ; R = 0.15; p = 0.0003. Knowledge of the disease symptoms in 2KE was associated with the patient’s expectations in RHD-MIS - a higher level of knowledge was associated with higher patient expectations, respectively: 73.2 ± 21.7%, 80.0 ± 18.5%, 82.9 ± 19.2 for low, medium and high RHDMIS (p = 0.02); R = 0.19; p = 0.006. There was no correlation between ΔKE or 2KE and ACDS results 6 months after discharge. Conclusions: The educational brochure is an effective tool in improving patients’ level of knowledge. Better knowledge of the symptoms of coronary artery disease and myocardial infarction is associated with a higher degree of readiness for discharge from the hospital but does not affect the observance of therapeutic recommendations in the field of pharmacotherapy after 6 months.