Person-centred care after acute coronary syndrome, from hospital to primary care — A randomised controlled trial

Abstract

AimTo evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome. Method199 patients with acute coronary syndrome <75years were randomly assigned to person-centred care intervention or treatment as usual and followed for 6months. In the intervention group a person-centred care process was added to treatment as usual, emphasising the patient as a partner in care. Care was co-created in collaboration between patients, physicians, registered nurses and other health care professionals and documented in a health plan. A team-based partnership across three health care levels included transparent knowledge about the disease and medical state to achieve agreed goals during recovery. Main outcome measure was a composite score of changes in general self-efficacy ≥5units, return to work or prior activity level and re-hospitalisation or death. ResultsThe composite score showed that more patients (22.3%, n=21) improved in the intervention group at 6months compared to the control group (9.5%, n=10) (odds ratio, 2.7; 95% confidence interval: 1.2–6.2; P=0.015). The effect was driven by improved self-efficacy ≥5units in the intervention group. Overall general self-efficacy improved significantly more in the intervention group compared with the control group (P=0.026). There was no difference between groups on re-hospitalisation or death, return to work or prior activity level. ConclusionA person-centred care approach emphasising the partnership between patients and health care professionals throughout the care chain improves general self-efficacy without causing worsening clinical events.