Acute Coronary Syndrome Clinical Trial
Official title:
Effectiveness of Advanced Practice Nurse-Led Telehealth on Readmissions and Health Related Outcomes Amongst Patients Post Acute Myocardial Infarction: ALTRA Study
Aim. To develop and examine the effectiveness of an APN-led telehealth rehabilitative
programme as a transitional nursing therapeutic on readmission rates and health related
outcomes amongst patients with Acute Myocardial Infarction (AMI) post discharge.
Design. Randomized controlled trial with repeated measures.
Methodology. A consecutive sampling of 172 patients with AMI will be recruited from a
tertiary hospital in Singapore. Participants will be randomised into two groups. The
experimental group (ALTRA) will receive APN-led telehealth rehabilitative programme upon
discharge in addition to standard care. The control group will receive only standard
follow-up care.
Ischaemic heart disease is the third leading cause both for death and illness for
hospitalisation in Singapore. Epidemiological data shows that the incidence of acute
myocardial infarction (AMI) stands around 7000 plus in Singapore. In United States, nearly
20% of patients with AMI are readmitted within 30 days of discharge causing the healthcare
system a huge financial burden. These readmissions have been shown to be associated with
lower patient satisfaction and less inefficient healthcare.
Cardiac rehabilitation has been proven to be an effective strategy in improving quality of
life and reducing readmission. However, this structured programme which comprise of clinical
review, education and exercise, has poor uptake rate for varied reasons. It is important that
newer strategies are being explored and developed to cater to the changing needs of the
patient population. One of which is to utilize telemedicine with combination of Advanced
Practice Nurse delivering the care remotely.
This is a substudy of IMMACULATE STUDY (NCT02468349) where more details can be found.
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