利用远程医疗对心肌梗塞后患者进行随访:利益相关者的教育、结果和客户满意度

Manuela Bocchino, Francesco Gabbrielli, G. Pastena, N. Danisi, Fabio Ferranti, Raffaele Scardala, Mariagrazia Romano, Claudia Sorrentino, Fabrizio Ammirati
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摘要

背景。关于心肌梗塞后利用远程医疗进行随访的研究很少。我们组织了一支专门的团队,提供出院后远程医疗服务。为此,有必要对参与组织和使用远程医疗服务的所有利益相关者进行适当的教育和宣传。方法。我们设计了一个理论与实践相结合的微型课程来培训医护人员,提高他们的技能,并取得了良好的学习效果和满意度。此后,我们招募了 STEMI(ST 段抬高的急性心肌梗死)、MINOCA(无阻塞性冠状动脉粥样硬化的心肌梗死)、Takotsubo 综合征或自发性冠状动脉夹层以及无 ST 段抬高的高危急性心肌梗死(NSTEMI)患者。出院时,心脏科技师为患者提供咨询服务,并在 1 个月和 4 个月时利用电视等区域平台,监测主要心脏不良事件 (MACE)、心力衰竭、心律失常、不稳定型心绞痛和非心血管事件、治疗依从性、目标治疗和客户满意度。结果2021 年 11 月至 2023 年 2 月期间,我们招募了 110 名患者:其中 72% 为 STEMI 患者,22% 为 NSTEMI 患者。在 1 个月的随访中,12 名患者未达到血压目标,23 名患者未达到低密度脂蛋白目标。我们观察到 3 名患者需要再次入院,3 名患者需要到医院接受进一步检查,1 名患者死亡。迄今为止,已对 54 名患者进行了为期四个月的随访。没有发生再次入院或死亡的情况。我们发现客户满意率为 96%。结论一个拥有专业团队的健康协调中心可以安全地对心肌梗死患者进行电视随访。在此之前,医疗保健专业人员必须掌握理论知识和最新信息,并掌握手工、技术和实践技能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Follow-Up of Post Myocardial Infarction Using Telemedicine: Stakeholders’ Education, Results and Customer Satisfaction
Background. There are few studies about post myocardial infarction follow-up using telemedicine. We organized a post-discharge telemedicine service with a dedicated team. To do this, it was necessary that all stakeholders involved in the organization and use of the telemedicine service were properly educated and informed. Methods. We designed a theoretical–practical mini-course to train healthcare personnel and increase skills, with excellent learning outcomes and satisfaction. Thereafter, we enrolled patients affected by acute myocardial infarction with ST elevation (STEMI), MINOCA (myocardial infarction with no obstructive coronary atherosclerosis), Takotsubo syndrome or spontaneous coronary dissection, and high-risk acute myocardial infarction without ST elevation (NSTEMI). At discharge, the cardiology technician performed counselling for the patient, using regional platforms, such as televisit, at 1 and 4 months, allowed us to monitor major adverse cardiac events (MACE), heart failure, arrhythmias, unstable angina and non-cardiovascular events, therapy adherence, target therapy and customer satisfaction. Results. Between November 2021 and February 2023, we enrolled 110 patients: 72% affected by STEMI, 22% by NSTEMI. At the 1-month follow up, 12 patients did not reach the pressure target and 23 patients did not reach the LDL target. We observed three patients requiring hospital readmission, three requiring hospital visits for further investigation, and one death. To date, a four month follow up was performed for 54 patients. No readmissions or deaths occurred. We detected a rate of 96% of customer satisfaction. Conclusions. A health coordination center with a dedicated team makes televisit safe as a follow-up for post-myocardial infarction patients. Beforehand, it is fundamental for healthcare professionals to acquire theoretical knowledge and updates, and the acquisition of manual, technical and practical skills.
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