Implementation of an Anti-Platelet Medication Education Process and Post-Discharge Motivational Phone Calls for Post Cardiac Stent Patients

摘要

Premature Clopidogrel discontinuation is the single most crucial culprit of stent thrombosis (40.8%)with a mortality rate >25%. Dual antiplatelet therapy with aspirin and P2Y12 antagonist are a critical component of treatment following PCI to prevent stent thrombosis and related life-threatening complications (Cutlip, 2016). Patients with poor medication adherence to antiplatelet therapy are at high risk for stent thrombosis and recurrent coronary events and often experience the worse outcomes (Palacio et al., 2014).;The aim of the project: Implement a multidisciplinary teaching and post-discharge motivational phone calls to post PCI patients to improve antiplatelet therapy medication adherence and prescription filling behaviors to reduce acute and sub acute stent thrombosis.;Methods: The team enrolled 34 participants who underwent PCI from June 2017 to October 2017. A multidisciplinary teaching implemented to the participants post PCI by an interdisciplinary team along with motivational phone calls within 24 hours and 30-days post discharge to evaluate medication adherence and prescription filling behaviors.;Project Results: A paired sample t-test is used to assess pre and post-intervention showed a significant increase in patient's medication adherence (t= 15.14, p =<0.001) and prescription filling behavior (t=-16.82, p=<0.001), no stent thrombosis reported in 30days, 91.7% of participants filled the prescription on time.;Conclusion: A multidisciplinary teaching and follow-up phone calls after discharge in post PCI patients will significantly improve patient's antiplatelet medication adherence, and prescription filling behaviors consequently reduce acute and sub acute coronary stent thrombosis.