Characterization of therapeutic programs headed at post-myocardial infarction patients or at risk of: a scoping review

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Worldwide stays confirmed that more than 7 million people experience acute myocardial infarction, in which one-year mortality rates range from 10%. The consequences are more dramatic among patients who survived because they are 20% likely to suffer a second cardiovascular event in the first year and mostly occur in those with a previous hospital discharge. Evidence has shown that prevention after a myocardial infarction has been positively associated with an improvement in its prognosis. The European Society of Cardiology was determined to embrace this challenge, endorsing the crucial role of secondary programs. However, recent studies allow us to state some gaps between the correlation of some important variables, related to secondary programs and patients that should be considered to reinforce good intervention practices. Purpose To analyze data capable of characterizing therapeutic programs considering the correlation between variables such as quality indicators, settings of implementation, use of digital technology, health professionals/organization enrolled, and the program's overall length. Methods We performed the analyses in different electronic databases, including published studies from 2007 to September 2022 that reported health therapeutic programs headed post at post-myocardial infarction patients or at risk. After identifying 609 titles, and screening 131 articles, accepting 20 full-text for systematic analysis. Results 16 studies included outpatient presence requirements in the relationship with the health care provider; 4 studies used mobile phone/ digital applications in patient health communication; 3 programs included multi-professional collaboration, the other 7 studies were single-professional with relevance to psychologists and physiotherapists; only 3 studies were conducted in the community setting; Overall, the maximum of programs length ranged from 3 to 42 months; Only 4 studies evaluated the efficiency of the interventions, considering the cost to the organization of the programs and the hospitalized patients; 18 studies related their efficiency based on changes in patient's health behavior and biological parameters. Overall, in terms of the methodology outlined 60% of the studies used a quantitative design, 10% used a mixed plan, and 15% did not refer to it. Conclusions we confirmed the absence of prior guidelines for secondary programs' uniformization, which corroborate the need affirmed for the European Society of Cardiology of endorsing the crucial role and the impact of secondary programs on patient`s health path, tailored to patients needs. We highlight the importance of using mixed methodologies, and prospective design capable of capturing the whole phenomenon. We did not identify any study considering the interoperability of health organizations as a strategy capable of adding value.