Commentary: The effect of the continuous care model on treatment adherence in patients with myocardial infarction: a randomised clinical trial.

Abstract

With my background as a cardiology research nurse, I was interested in reading the results of this study. My work has involved the follow up of patients who have had a myocardial infarction (MI), from a clinical-trial perspective, and often, such follow-up periods can be extensive. The assertion that there is a global problem with treatment adherence post-MI resonates to a degree with my own experience in a comparably small part of the globe. The author compares a continuous care model (CCM) with routine care in 82 patients who had been diagnosed with a MI. From the study description, I was unable to determine the specifics of what constituted routine care, which was a shame as I think it would have helped me to understand the study better. However, the description of the intervention is clear, and the results of the study indicate that: those who received CCM, which included a comprehensive post-discharge support system, demonstrated significantly higher adherence to treatment immediately after training and follow-up. The conclusion from the author is that CCM is recommended as an intervention to increase treatment adherence in MI patients and cardiac-rehabilitation programmes. However, as they themselves point out, they have chosen one educational model and that has been implemented in a single centre in one country. When we are looking to improve adherence to treatment on a global scale, it seems that a global appraisal needs to take place and they rightly advise that any generalisation be done with caution. The study does, however, build on work that has already been done, looking at the impact of a CCM on specific health-care outcomes in a variety of patient groups and so it is certainly not an isolated study without significance.