Person-centred care after acute coronary syndrome, from hospital to primary care - A randomised controlled trial
- Person-centred care in the recovery after an acute coronary syndrome event,
- Details of a co-created health plan to produce a partnership between patients and health care professionals,
- The transition of care continuing the partnership from in-hospital care to primary care,
- Improved self-efficacy by including a partnership compared to standard care alone.
To evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome.
199 patients with acute coronary syndrome < 75 years were randomly assigned to person-centred care intervention or treatment as usual and followed for 6 months. In the intervention group a person-centred care process was added to treatment as usual, emphasising the patient as a partner in care. Care was co-created in collaboration between patients, physicians, registered nurses and other health care professionals and documented in a health plan. A team-based partnership across three health care levels included transparent knowledge about the disease and medical state to achieve agreed goals during recovery. Main outcome measure was a composite score of changes in general self-efficacy ≥ 5 units, return to work or prior activity level and re-hospitalisation or death.
The composite score showed that more patients (22.3%, n = 21) improved in the intervention group at 6 months compared to the control group (9.5%, n = 10) (odds ratio, 2.7; 95% confidence interval: 1.2–6.2; P = 0.015). The effect was driven by improved self-efficacy ≥ 5 units in the intervention group. Overall general self-efficacy improved significantly more in the intervention group compared with the control group (P = 0.026). There was no difference between groups on re-hospitalisation or death, return to work or prior activity level.
A person-centred care approach emphasising the partnership between patients and health care professionals throughout the care chain improves general self-efficacy without causing worsening clinical events.