High post-discharge care continuity doubled treatment adherence (aOR=2.50) and halved anxiety/depression risk (aOR=0.48) in myocardial infarction survivors.
Does high post-discharge care continuity improve treatment adherence and reduce anxiety/depressive symptoms in adults with first-time acute myocardial infarction?
Higher post-discharge care continuity is associated with improved medication adherence, better psychological wellbeing, and reduced cardiovascular risk in myocardial infarction survivors.
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ABSTRACT Background Post‐discharge care continuity represents a modifiable factor influencing outcomes in myocardial infarction survivors, yet its multidimensional relationship with treatment adherence and psychological morbidity remains underexplored. Methods This retrospective cohort study analysed 452 adults with first‐time acute myocardial infarction discharged between 2019 to 2024 from Beijing Tongren Hospital. Care continuity was quantified via a validated 10‐point score (0–10) assessing follow‐up frequency (0–4 points), content coverage (0–3 points), and multidisciplinary coordination (0–3 points). Participants were stratified into low (≤ 3 points, n = 231), moderate (4–6 points, n = 157), and high continuity (≥ 7 points, n = 64) groups. Primary outcomes were 6‐month treatment adherence (composite of medication possession ratio ≥ 80% for ≥ 2 core medications and ≥ 75% scheduled visit completion) and anxiety/depression symptoms (PHQ‐9 ≥ 10, GAD‐7 ≥ 8, or clinical diagnosis). Multivariable logistic regression adjusted for sociodemographic, clinical, and psychological confounders. Results High continuity care demonstrated significantly increased treatment adherence versus low continuity (adjusted odds ratio aOR = 2.50, 95% confidence interval CI: 1.82–3.42) and reduced anxiety/depression symptoms (aOR = 0.48, 95% CI: 0.30–0.77). Each 1‐point continuity increase improved adherence by 22% (aOR = 1.22, 95% CI: 1.15–1.30) and decreased psychological risk by 13% (aOR = 0.87, 95% CI: 0.82–0.93). Absolute adherence difference between high and low continuity groups was 35.1% (number needed to treat = 3). Cardiovascular events decreased progressively across continuity levels (low: 22.1%, moderate: 12.7%, high: 7.8%; p = 0.003), with high continuity independently reducing event risk by 58% (aOR = 0.42, 95% CI: 0.24–0.73). Urban residence and higher left ventricular ejection fraction predicted better continuity access. Conclusion Quantified care continuity exhibits a dose‐dependent association with superior medication adherence, psychological wellbeing, and reduced cardiovascular risk in myocardial infarction survivors. Optimising continuity represents a high‐yield strategy for secondary prevention.
Hou et al. (Sun,) reported a other. High post-discharge care continuity doubled treatment adherence (aOR=2.50) and halved anxiety/depression risk (aOR=0.48) in myocardial infarction survivors.