Advanced Practice Nurse University of Ottawa Heart Institute Ottawa, Ontario, Canada
Background: Spontaneous coronary artery dissection (SCAD), once believed to be a rare condition, is increasingly recognized as a cause of myocardial infarction. Patients with SCAD report a greater need for SCAD-specific information and support, particularly in the early phase before they receive follow-up with their cardiologist or cardiovascular rehabilitation (CR) program. A virtual post discharge class was developed to support patients during this transition.
METHODS AND RESULTS: The class is taught by an Advanced Practice Nurse and Physiotherapist. This monthly presentation includes the following content: What is SCAD, who is affected, signs and symptoms, associated factors, precipitating stressors, diagnostic tests, medications, exercise with a focus on everyday living, psychosocial factors, and a review of available resources, followed by a question-and-answer period. Patients are then asked to complete a Patient Reported Experience Measure (PREM). For 1 year, all SCAD patients (N=36) identified in hospital were invited to the session via their electronic medical record (EMR) and a telephone invitation the week prior to the scheduled class. During this pilot phase, 27 patients attended (75 % enrollment). Initial PREM completion rates were low, so a QR code was generated, and time was provided at the end of the session for completion. Preliminary PREM data (n=11) indicated patients agreed (18%) or strongly agreed (82%) that the information met their needs. Many patients (64%) reported less stress after receiving the information provided. Almost all the participants (91%) agreed that they feel more confident managing their health and activities because of the information they received in the class. All (100%) of participants found the class helpful in their recovery. Qualitative data also highlighted that the patients valued this class, and the information provided and viewed it as an important first link to outpatient health care providers (HCPs).
Conclusion: The recovery needs of patients with SCAD continue to be elucidated. When patients are discharged from the hospital, they may not have follow-up for 6-8 weeks or more. Early connections with HCPs provides an opportunity for SCAD-specific information to be delivered and help patients have their questions answered. Offering a class to help bridge the gap for these patients has shown to decrease their stress and help them manage living with SCAD when returning home. As this class is offered virtually, further expansion beyond the region is a possibility to further grow and help support this patient population.
