Does Telephone Follow-up After Myocardial Revascularization Help?May 3, 2013
By Sylvia Foley, AJN senior editor
Myocardial revascularization, an established treatment for coronary heart disease, is currently done via either percutaneous coronary intervention or coronary artery bypass graft surgery. But recovery and rehabilitation can be hard going, and patients need close monitoring. Investigators Rejane K. Furuya and colleagues wanted to learn more about the use of telephone follow-up with such patients. To that end, they searched the literature, identified relevant studies, and assessed and synthesized the results. In this month’s original research CE, “Telephone Follow-Up for Patients After Myocardial Revascularization: A Systematic Review,” they report on their findings. Here’s a short summary.
The review was conducted in accordance with the Cochrane method. The researchers searched six electronic databases for articles on clinical trials that studied patients after myocardial revascularization using telephone follow-up and were published in English, Spanish, or Portuguese. Of 170 identified studies, seven met the inclusion criteria and were analyzed.
Some findings. Both the purposes and contents of telephone follow-up varied in the analyzed studies. The researchers found that the contents could be grouped into four themes—cardiovascular illness; postoperative complications; self-care, including behavioral and lifestyle changes; and psychosocial evaluation and emotional support. Outcome measures also varied widely, but included health-related quality of life, pain, enrollment in cardiac rehabilitation programs, physical functioning, hospital readmission, mood symptoms, and medication compliance. Telephone follow-up was found to be “an effective intervention for most of the outcomes assessed.”
The researchers also explored various elements of telephone follow-up, such as the timing of follow-up, the number of calls made, and who was responsible for initiating calls. They noted that
in five of the seven analyzed studies, nurses performed the telephone follow-up; and in all five the content was more comprehensive, covering both education and counseling for patients discharged after myocardial revascularization.
Furuya and colleagues concluded that the findings support the use of telephone follow-up “to periodically assess patient knowledge, discuss patient concerns and offer help in addressing them, monitor mood symptoms and anxiety levels, and encourage behavioral and lifestyle changes.” But more research is needed to identify the optimal content and frequency, number, and duration of calls.
For full details, please read the article—it’s free online. And as always, we welcome your comments!