High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study
Franz Goss,1 Johannes Brachmann,2 Christian W Hamm,3 Winfried Haerer,4 Nicolaus Reifart,5 Benny Levenson6 1Herzzentrum Alter Hof, München, Germany; 2Klinikum Coburg GmbH, II. Medizinische Klinik, Coburg, Germany; 3Kerckhoff Klinik GmbH, Kardiologie, Bad Nauheim, Germany; 4Herzklinik Ulm, Ul...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2017-04-01
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| Series: | Vascular Health and Risk Management |
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| Online Access: | https://www.dovepress.com/high-adherence-to-therapy-and-low-cardiac-mortality-and-morbidity-in-p-peer-reviewed-article-VHRM |
| _version_ | 1811239834586447872 |
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| author | Goss F Brachmann J Hamm CW Haerer W Reifart N Levenson B |
| author_facet | Goss F Brachmann J Hamm CW Haerer W Reifart N Levenson B |
| author_sort | Goss F |
| collection | DOAJ |
| description | Franz Goss,1 Johannes Brachmann,2 Christian W Hamm,3 Winfried Haerer,4 Nicolaus Reifart,5 Benny Levenson6 1Herzzentrum Alter Hof, München, Germany; 2Klinikum Coburg GmbH, II. Medizinische Klinik, Coburg, Germany; 3Kerckhoff Klinik GmbH, Kardiologie, Bad Nauheim, Germany; 4Herzklinik Ulm, Ulm, Germany; 5Kardiologische Praxis Prof. Reifart & Partner, Bad Soden, Germany; 6Kardiologische Gemeinschaftspraxis und Herzkatheterlabor Berlin-Charlottenburg, Berlin, Germany Abstract: We aimed to assess patient acceptance and effectiveness of a 12-month structured management program in patients after an acute coronary syndrome (ACS) event who were treated in a special setting of office-based cardiologists. The program comprised patient documentation with a specific tool (Bundesverband Niedergelassener Kardiologen [German Federation of Office-Based Cardiologists] cardiac pass with visit scheduling) shared by the hospital physician and the office-based cardiologist, the definition of individual treatment targets, and the systematic information of patients in order to optimize adherence to therapy. Participating centers (36 hospitals, 60 office-based cardiologists) included a total of 1,003 patients with ACS (ST-segment elevation myocardial infarction [STEMI] 44.3%, non-ST-segment elevation myocardial infarction [NSTEMI] 39.5%, unstable angina pectoris [UA] 15.2%, and unspecified 1.0%). During follow-up, treatment rates with cardiac medication remained high in all groups, with dual antiplatelet therapy in 91.0% at 3 months, 90.0% at 6 months, and 82.8% at 12 months, respectively. Twelve months after the inclusion, a total of 798 patients (79.6%) still participated in the program. Eighteen patients (1.8%) had died after discharge from hospital (6 in the STEMI, 12 in the NSTEMI group), while for 58 the status was unknown (5.8%). Based on a conservative approach that considered patients with unknown status as dead, 1-year mortality was 7.6%. Recurrent cardiac events were noted in14.9% at 1 year, with an about equal distribution across STEMI and NSTEMI patients. In conclusion, patients’ acceptance of the ProAcor program as determined by adherence rates over time was high. Treatment rates of recommended medications used for patients with coronary heart disease were excellent. The 1-year mortality rate was comparatively low. Keywords: myocardial infarction, patient management, patient education, feedback, ­patient-oriented outcomes, therapy adherence, compliance, mortality, quality of life |
| first_indexed | 2024-04-12T13:08:06Z |
| format | Article |
| id | doaj.art-6e9dc0193e7d4a1a9438b29b3ad791f4 |
| institution | Directory Open Access Journal |
| issn | 1178-2048 |
| language | English |
| last_indexed | 2024-04-12T13:08:06Z |
| publishDate | 2017-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Vascular Health and Risk Management |
| spelling | doaj.art-6e9dc0193e7d4a1a9438b29b3ad791f42022-12-22T03:31:56ZengDove Medical PressVascular Health and Risk Management1178-20482017-04-01Volume 1312713732262High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor StudyGoss FBrachmann JHamm CWHaerer WReifart NLevenson BFranz Goss,1 Johannes Brachmann,2 Christian W Hamm,3 Winfried Haerer,4 Nicolaus Reifart,5 Benny Levenson6 1Herzzentrum Alter Hof, München, Germany; 2Klinikum Coburg GmbH, II. Medizinische Klinik, Coburg, Germany; 3Kerckhoff Klinik GmbH, Kardiologie, Bad Nauheim, Germany; 4Herzklinik Ulm, Ulm, Germany; 5Kardiologische Praxis Prof. Reifart & Partner, Bad Soden, Germany; 6Kardiologische Gemeinschaftspraxis und Herzkatheterlabor Berlin-Charlottenburg, Berlin, Germany Abstract: We aimed to assess patient acceptance and effectiveness of a 12-month structured management program in patients after an acute coronary syndrome (ACS) event who were treated in a special setting of office-based cardiologists. The program comprised patient documentation with a specific tool (Bundesverband Niedergelassener Kardiologen [German Federation of Office-Based Cardiologists] cardiac pass with visit scheduling) shared by the hospital physician and the office-based cardiologist, the definition of individual treatment targets, and the systematic information of patients in order to optimize adherence to therapy. Participating centers (36 hospitals, 60 office-based cardiologists) included a total of 1,003 patients with ACS (ST-segment elevation myocardial infarction [STEMI] 44.3%, non-ST-segment elevation myocardial infarction [NSTEMI] 39.5%, unstable angina pectoris [UA] 15.2%, and unspecified 1.0%). During follow-up, treatment rates with cardiac medication remained high in all groups, with dual antiplatelet therapy in 91.0% at 3 months, 90.0% at 6 months, and 82.8% at 12 months, respectively. Twelve months after the inclusion, a total of 798 patients (79.6%) still participated in the program. Eighteen patients (1.8%) had died after discharge from hospital (6 in the STEMI, 12 in the NSTEMI group), while for 58 the status was unknown (5.8%). Based on a conservative approach that considered patients with unknown status as dead, 1-year mortality was 7.6%. Recurrent cardiac events were noted in14.9% at 1 year, with an about equal distribution across STEMI and NSTEMI patients. In conclusion, patients’ acceptance of the ProAcor program as determined by adherence rates over time was high. Treatment rates of recommended medications used for patients with coronary heart disease were excellent. The 1-year mortality rate was comparatively low. Keywords: myocardial infarction, patient management, patient education, feedback, ­patient-oriented outcomes, therapy adherence, compliance, mortality, quality of lifehttps://www.dovepress.com/high-adherence-to-therapy-and-low-cardiac-mortality-and-morbidity-in-p-peer-reviewed-article-VHRMMyocardial infarctionpatient managementcarepatient educationfeedbackpatient-oriented outcomestherapy adherencecompliancemortalityquality of life. |
| spellingShingle | Goss F Brachmann J Hamm CW Haerer W Reifart N Levenson B High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study Vascular Health and Risk Management Myocardial infarction patient management care patient education feedback patient-oriented outcomes therapy adherence compliance mortality quality of life. |
| title | High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study |
| title_full | High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study |
| title_fullStr | High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study |
| title_full_unstemmed | High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study |
| title_short | High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study |
| title_sort | high adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office based cardiologists in germany 1 year outcomes of the proacor study |
| topic | Myocardial infarction patient management care patient education feedback patient-oriented outcomes therapy adherence compliance mortality quality of life. |
| url | https://www.dovepress.com/high-adherence-to-therapy-and-low-cardiac-mortality-and-morbidity-in-p-peer-reviewed-article-VHRM |
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