Effects of person-centred care after an event of acute coronary syndrome: Two-year follow-up of a randomised controlled trial

Abstract

Aim: To assess the long-term effect of person-centred care (PCC) in patients with acute coronary syndrome (ACS).

Method: Patients with ACS were randomly assigned to treatment as usual (control group) or an added PCC intervention for six months. The primary endpoint was a composite score of changes in general self-efficacy≥five units, return to work or to a prior activity level and re-hospitalisation or death.

Results: The composite score improved in the PCC intervention group (n=94) at a two-year follow-up compared with the control group (n=105) (18.1%, n=17 vs. 10.5%, n=11; P=0.127). In the per-protocol analysis (n=183) the improvement was significant in favour of the PCC intervention (n=78) compared with usual care (n=105) (21.8%, n=17 vs. 10.5%, n=11; P=0.039). This effect was driven by the finding that more patients in the PCC group improved their general self-efficacy score≥5units (32.2%, n=19 vs. 17.3%, n=14; P=0.046). The composite score improvement was significantly higher in the PCC intervention group without post-secondary education (n=33) in comparison with corresponding patients in the control group (n=50) (30.3%, n=10 vs. 10.0%, n=5; P=0.024).

Conclusion: Implementation of PCC results in sustained improvements in health outcome in patients with ACS. PCC can be incorporated into conventional cardiac prevention programmes to improve equity in uptake and patient health outcomes.

Trial registration: Swedish registry, Researchweb.org, ID NR 65791.

Keywords: Acute coronary syndrome; Cardiac rehabilitation; Patient-centered care; Person-centred care; Randomised controlled trial; Self-efficacy.