Key result
High post-discharge care continuity linked to ~2.5-fold higher 6-month treatment adherence.
Why the study?
Post-discharge care continuity influences outcomes in myocardial infarction survivors, but its multidimensional relationship with treatment adherence and psychological morbidity remains underexplored.
Does high post-discharge care continuity improve treatment adherence and reduce anxiety-depressive symptoms in myocardial infarction survivors?
Cohort (n=452)
No
Does high post-discharge care continuity improve treatment adherence and reduce anxiety-depressive symptoms in myocardial infarction survivors?
Odds Ratio: 2.5 (95% CI 1.82–3.42)
Absolute Event Rate: 70.3% vs 35.2%
Absolute Risk Reduction: 35.1%
Number Needed to Treat: 3
p-value: p=<0.001
Higher post-discharge care continuity is strongly and dose-dependently associated with better long-term medication adherence, fewer psychological symptoms, and lower cardiovascular event rates following myocardial infarction.
May support continuity-focused follow-up after MI; hypothesis-generating and requires prospective trials before practice change.
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.
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Hou et al. (2026) conducted a cohort in First-time acute myocardial infarction (n=452). High care continuity (≥ 7 points on a 10-point scale) vs. Low care continuity (≤ 3 points) was evaluated on 6-month treatment adherence (aOR 2.50, 95% CI 1.82-3.42, p=<0.001). High post-discharge care continuity significantly increased 6-month treatment adherence compared to low continuity (70.3% vs 35.2%; aOR 2.50).
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