Effects of Nurse-led Case Management Based on Prevention and Control of Acute Myocardial Infarction

Study Overview
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Brief Summary
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Acute Myocardial Infarction (AMI) is a major disease that endangers people's health China. At present, clinical emphasis is given to treatment rather than prevention, and a large number of AMI patients are hospitalized repeatedly without systematic and standardized health management after acute stage, falling into a vicious circle of treatment without recovery. Nurse-led case management based on multidisciplinary collaboration is a new mode of disease management. In 1994, the United States took the lead in applying case management to the acute and chronic care system, providing comprehensive care services and promoting comprehensive recovery through multidisciplinary collaboration led by case managers. At present, the case management model of cardiovascular disease in Europe and the United States has been mature, but it is still in the exploratory stage in China. Through the establishment and application of nurse-led AMI case management program based on multidisciplinary collaboration, this study wants to establish a novel, standardized, and easy to popularize AMI whole-course prevention and control mode, providing theoretical and research basis for AMI disease management.

Detailed Description
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There are few domestic studies on cardiovascular disease case management in China, and the studies mainly aimed at the application of case management in out-of-hospital follow-up management. At present, there has been no reports on nurse-led the multidisciplinary whole course case management of AMI patients from admission to discharge, diagnosis and treatment, rehabilitation and secondary prevention. This study would apply case management to the whole course management of AMI patients from admission to 6 months after discharge. Pharmacists, nutritionists, rehabilitation specialists and psychiatrists coordinated by nurse would take the initiative to conduct individualized assessment and health guidance, and case managers would participate in the whole process of inpatient diagnosis and treatment. Coordinating multidisciplinary medical resources to jointly implement diagnosis and treatment and rehabilitation for patients can save medical costs and improve the quality of care.

Official Title
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Effects of Nurse-led Case Management Based on Multidisciplinary Collaboration in the Whole Course Prevention and Control of Acute Myocardial Infarction

Conditions
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Acute Myocardial Infarction

Intervention / Treatment
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* Other: Nurse -led case management
* Other: Routine inpatient care and post-discharge follow-up management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: In line with the diagnosis of Chinese 2019 Guidelines for AMI. Age greater than or equal to 18 years old and less than or equal to 75 years old Patients have clear consciousness and agree to participate in this study. Exclusion Criteria: Verbal communication disorders. Patients have a clear history of allergic constitution, and have allergies or intolerance to the drugs recommended by the guidelines (including antiplatelet drugs, ẞ receptor blockers, statins, various antihypertensive and hypoglycemic drugs, etc.). Patients have severe heart, brain, liver, kidney, motor dysfunction.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental<br>Patients in the experimental group will receive full-course case management from a multidisciplinary team from admission to 6 months after discharge | Other: Nurse -led case management<br>* This study would apply case management to the whole course management of AMI patients from admission to 6 months after discharge. Pharmacists, nutritionists, rehabilitation specialists and psychiatrists led by nurse would take the initiative to conduct individualized assessment and health guidance, and case managers would participate in the whole process of inpatient diagnosis and treatment. Coordinating multidisciplinary medical resources to jointly implement diagnosis and treatment and rehabilitation for patients can improve the quality of care.<br>|
| Active Comparator: Control<br>Patients in the control group will receive routine inpatient care and post-discharge follow-up management | Other: Routine inpatient care and post-discharge follow-up management<br>* Patients in the control group will receive routine inpatient care and post-discharge follow-up management<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The 36-item Short Form Health Survey for HRQoL | Health-related quality of life | from baseline to 6 months after discharge | 
| Coronary artery disease self-management scale for self-management behaviors | Self-management behaviors | from baseline to 6 months after discharge | 
| the numbers of unplanned readmission | Unplanned readmission | Through study completion, within 6 months post discharge | 
| the number of deaths from cardiac causes | Deaths from cardiac causes | Through study completion,within 6 months post discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the numbers of no smoking | Smoking | from baseline to 6 months after discharge | 
| systolic and diastolic blood pressure （mmHg） | Blood Pressure. | from baseline to 6 months after discharge | 
| Glycated hemoglobin A1c （%） | Collect fasting venous blood to measure glycosylated hemoglobin A1c | from baseline to 6 months after discharge | 
| Body mass index (BMI)，kg/m2 | Measure weight and height，then weight and height will be combined to report BMI in kg/m^2 | from baseline to 6 months after discharge | 
| Low-density lipoprotein （mmol/L） | Collect fasting venous blood to measure low-density lipoprotein | from baseline to 6 months after discharge | 
| Exercise time every week （min） | Inquire the exercise time per week | from baseline to 6 months after discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute Myocardial Infarction, case management