The influence of treatment modality on illness perception and secondary prevention outcomes among patients with acute myocardial infarction

Objectives:This study aims to determine if patients with acute myocardial infarction differ in illness perception and secondary prevention outcomes depending on the treatment they received.Methods:A repeated measures design was used to compare patients with acute myocardial infarction receiving three different treatment modalities:ST-elevation myocardial infarction treated by primary percutaneous coronary intervention,ST-elevation myocardial infarction treated by thrombolytic therapy,and non ST-elevation myocardial infarction treated by medication.A convenient sampling technique was used to recruit 206 patients with acute myocardial infarction who agreed to participate in the current study.Patients'illness perception,physical activity,and demographical and clinical data were collected during hospital admission and again at 6 months.Results:A total of 186 patients completed the study.Results showed that the primary percutaneous coronary intervention group perceived their illness as acute rather than chronic(P=0.034)and has lower personal control(P=0.032),higher treatment control(P=0.025),and higher perception of illness coherence(P=0.022)compared with patients receiving thrombolytic therapy and treated after non-ST segment infarction.Moreover,they report low control of their blood pressure(P=0.013)and less physical activity(P=0.001).Conclusion:The results of this study revealed that patients'treated with primary percutaneous coronary intervention had negative illness perception and limited behavioral changes 6 months after hospitalization in comparison with other treatment modalities such as percutaneous coronary intervention and thrombolytic treatment.Further research is recommended to confirm this association with longer follow-up study and among different cultures.

CODE-EHR:临床研究中运用结构化电子医疗记录的最佳实践框架

改善患者生存质量是全球临床医学的发展目标,大数据是实现其发展的关键所在。技术进步使结构化电子医疗记录得以常规化,也可能会改善缺失重要临床证据的问题。虽然大数据及其相关分析在新冠大流行期间发挥了重要作用,但也存在严重的缺陷。证实、核验、数据隐私以及对科学研究社会责任的践行是一项重要挑战。欧洲心脏病协会和BigData@Heart联盟已经收集了包括患者代表、临床医生、科研人员、监管机构、期刊编辑和企业代表在内的多元化国际参与者,提出了CODE-EHR的最低标准框架。为改进研究设计、提高信息透明度提供方法手段,同时为实现医疗保健数据的稳健并能够有效运用制定了技术路线图。