‘Routine’ versus ‘Smart Phone Application Based – Intense’ follow up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: Impact on clinical outcomes and patient satisfaction
Background: Acute coronary syndrome (ACS) refers to the spectrum of clinical presentation of coronary artery disease (CAD). As a routine practice at our institute, following PCI, ACS patients are called for the first follow up after two weeks. This period of two weeks can be full of anxieties, conce...
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Elsevier
2021-08-01
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Series: | International Journal of Cardiology: Heart & Vasculature |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906721001202 |
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record_format |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Satyavir Yadav Rishi Sethi Akshyaya Pradhan Pravesh Vishwakarma Monika Bhandari Raghav Gattani Sharad Chandra Gaurav Chaudhary Akhil Sharma S.K. Dwivedi V.S. Narain Bhawna Rao Ambuj Roy |
spellingShingle |
Satyavir Yadav Rishi Sethi Akshyaya Pradhan Pravesh Vishwakarma Monika Bhandari Raghav Gattani Sharad Chandra Gaurav Chaudhary Akhil Sharma S.K. Dwivedi V.S. Narain Bhawna Rao Ambuj Roy ‘Routine’ versus ‘Smart Phone Application Based – Intense’ follow up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: Impact on clinical outcomes and patient satisfaction International Journal of Cardiology: Heart & Vasculature Acute coronary syndrome Routine versus intense follow up Smart phone app |
author_facet |
Satyavir Yadav Rishi Sethi Akshyaya Pradhan Pravesh Vishwakarma Monika Bhandari Raghav Gattani Sharad Chandra Gaurav Chaudhary Akhil Sharma S.K. Dwivedi V.S. Narain Bhawna Rao Ambuj Roy |
author_sort |
Satyavir Yadav |
title |
‘Routine’ versus ‘Smart Phone Application Based – Intense’ follow up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: Impact on clinical outcomes and patient satisfaction |
title_short |
‘Routine’ versus ‘Smart Phone Application Based – Intense’ follow up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: Impact on clinical outcomes and patient satisfaction |
title_full |
‘Routine’ versus ‘Smart Phone Application Based – Intense’ follow up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: Impact on clinical outcomes and patient satisfaction |
title_fullStr |
‘Routine’ versus ‘Smart Phone Application Based – Intense’ follow up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: Impact on clinical outcomes and patient satisfaction |
title_full_unstemmed |
‘Routine’ versus ‘Smart Phone Application Based – Intense’ follow up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: Impact on clinical outcomes and patient satisfaction |
title_sort |
‘routine’ versus ‘smart phone application based – intense’ follow up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: impact on clinical outcomes and patient satisfaction |
publisher |
Elsevier |
series |
International Journal of Cardiology: Heart & Vasculature |
issn |
2352-9067 |
publishDate |
2021-08-01 |
description |
Background: Acute coronary syndrome (ACS) refers to the spectrum of clinical presentation of coronary artery disease (CAD). As a routine practice at our institute, following PCI, ACS patients are called for the first follow up after two weeks. This period of two weeks can be full of anxieties, concerns and medical issues. In this study, we planned to assess the feasibility/acceptability of smart phone application (app) based system for patient follow-up and its comparison to routine practice among patients with ACS who have undergone a PCI. Methods: A randomized controlled trial (RCT) was conducted over a period of one year from January to December 2017. After the PCI was deemed successful, patients were recruited and enrolled based on the understanding of basic English language and operation of a smart phone. Those who consented to be part of study were then randomly allocated either the conventional follow up group or the intense follow up (routine + smart phone app based follow up) group. First co- primary outcome was composite of clinical outcomes (mortality, myocardial infarction, stroke, target vessel revascularisation, heart failure admission and emergency visit). Second co- primary outcome was patient satisfaction. The overall patient satisfaction was assessed by the patients using a five-point patient satisfaction survey instrument containing five questions with 5 marks each, in which higher scores meant more satisfaction. Secondary outcome was controlled hypertension in hypertensive patients. It was defined as systolic BP less than 130 and diastolic BP less than 80 mmHg. Results: A cohort of 228 patients (109 in intense app-based arm; 119 in routine follow up arm) were analyzed. The result showed significant improvement in blood pressure control in hypertensive population in intense app based follow up group (76.2%) when compared to routine follow up group (45%) with p value 0.0062. The satisfaction score was significantly higher in the intense app based follow up (20.7 ± 1.29) as compared to routine follow up (16.5 ± 2.68); p value 0.0001. In the intense app based follow up 72.5% patient felt it was excellent tool (score 21–25) while 27.5% categorized it as good (score 16–20). While the routine follows up was perceived as good by most (91.6%) of the patients. Only 4.2% graded it as excellent and an equal number (4.2%) graded it as a poor way of follow up. Conclusions: App based system shows higher satisfaction rate and comparable clinical outcome when compared to traditional hospital based follow up protocol alone. It has a high acceptance rate and thus this system should be explored further to optimize long term patient care. |
topic |
Acute coronary syndrome Routine versus intense follow up Smart phone app |
url |
http://www.sciencedirect.com/science/article/pii/S2352906721001202 |
work_keys_str_mv |
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doaj-f85e23c9985a4681be7ee369aac836fc2021-08-14T04:31:14ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672021-08-0135100832‘Routine’ versus ‘Smart Phone Application Based – Intense’ follow up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: Impact on clinical outcomes and patient satisfactionSatyavir Yadav0Rishi Sethi1Akshyaya Pradhan2Pravesh Vishwakarma3Monika Bhandari4Raghav Gattani5Sharad Chandra6Gaurav Chaudhary7Akhil Sharma8S.K. Dwivedi9V.S. Narain10Bhawna Rao11Ambuj Roy12Department of Cardiology, AIIMS, New Delhi, IndiaDepartment of Cardiology, King George’s Medical University, Lucknow, India; Corresponding author.Department of Cardiology, King George’s Medical University, Lucknow, IndiaDepartment of Cardiology, King George’s Medical University, Lucknow, IndiaDepartment of Cardiology, King George’s Medical University, Lucknow, IndiaEastern Virgina Medical School, United StatesDepartment of Cardiology, King George’s Medical University, Lucknow, IndiaDepartment of Cardiology, King George’s Medical University, Lucknow, IndiaDepartment of Cardiology, King George’s Medical University, Lucknow, IndiaDepartment of Cardiology, King George’s Medical University, Lucknow, IndiaDepartment of Cardiology, King George’s Medical University, Lucknow, IndiaNational AIDS Control Organisation, New Delhi, IndiaDepartment of Cardiology, AIIMS, New Delhi, IndiaBackground: Acute coronary syndrome (ACS) refers to the spectrum of clinical presentation of coronary artery disease (CAD). As a routine practice at our institute, following PCI, ACS patients are called for the first follow up after two weeks. This period of two weeks can be full of anxieties, concerns and medical issues. In this study, we planned to assess the feasibility/acceptability of smart phone application (app) based system for patient follow-up and its comparison to routine practice among patients with ACS who have undergone a PCI. Methods: A randomized controlled trial (RCT) was conducted over a period of one year from January to December 2017. After the PCI was deemed successful, patients were recruited and enrolled based on the understanding of basic English language and operation of a smart phone. Those who consented to be part of study were then randomly allocated either the conventional follow up group or the intense follow up (routine + smart phone app based follow up) group. First co- primary outcome was composite of clinical outcomes (mortality, myocardial infarction, stroke, target vessel revascularisation, heart failure admission and emergency visit). Second co- primary outcome was patient satisfaction. The overall patient satisfaction was assessed by the patients using a five-point patient satisfaction survey instrument containing five questions with 5 marks each, in which higher scores meant more satisfaction. Secondary outcome was controlled hypertension in hypertensive patients. It was defined as systolic BP less than 130 and diastolic BP less than 80 mmHg. Results: A cohort of 228 patients (109 in intense app-based arm; 119 in routine follow up arm) were analyzed. The result showed significant improvement in blood pressure control in hypertensive population in intense app based follow up group (76.2%) when compared to routine follow up group (45%) with p value 0.0062. The satisfaction score was significantly higher in the intense app based follow up (20.7 ± 1.29) as compared to routine follow up (16.5 ± 2.68); p value 0.0001. In the intense app based follow up 72.5% patient felt it was excellent tool (score 21–25) while 27.5% categorized it as good (score 16–20). While the routine follows up was perceived as good by most (91.6%) of the patients. Only 4.2% graded it as excellent and an equal number (4.2%) graded it as a poor way of follow up. Conclusions: App based system shows higher satisfaction rate and comparable clinical outcome when compared to traditional hospital based follow up protocol alone. It has a high acceptance rate and thus this system should be explored further to optimize long term patient care.http://www.sciencedirect.com/science/article/pii/S2352906721001202Acute coronary syndromeRoutine versus intense follow upSmart phone app |