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de Carvalho Costa IMNB, Silva DGD, Oliveira JLM, Silva JRS, Pereira LMC, Alves LVS, de Andrade FA, Góes Jorge JD, Oliveira LMSMD, Almeida RRD, Oliveira VB, Martins LS, Costa JO, de Souza MFC, Voci SM, Almeida-Santos MA, Abreu VV, Aidar FJ, Baumworcel L, Sousa ACS. Adherence to secondary prevention measures after acute coronary syndrome in patients associated exclusively with the public and private healthcare systems in Brazil. Prev Med Rep 2022; 29:101973. [PMID: 36161134 PMCID: PMC9502285 DOI: 10.1016/j.pmedr.2022.101973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/28/2022] [Accepted: 08/27/2022] [Indexed: 11/24/2022] Open
Abstract
Adherence to secondary prevention measures after acute coronary syndrome (ACS) is essential to prevent disease recurrence. In Brazil, the Brazilian Unified Health System (SUS, in Portuguese), and the private healthcare system (PHCS) coexist. We aimed to evaluate the adherence to secondary prevention in patients with ACS who were assisted by either SUS or PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, three of which assisted PHCS users, and one, SUS users. We analyzed the two patient care models with multiple logistic regression models for adherence to physical activity, pharmacotherapy, and smoking cessation. We enrolled 581 volunteers in this study: 44.1 % from SUS and 55.9 % from PHCS. PHCS users showed greater adherence to pharmacotherapy at both 30 and 180 (p = 0.001) days after ACS with better results in all classes of medications (p < 0.05) than SUS users did. They also showed better adherence to physical activity (p = 0.047). There was no distinction between the groups regarding smoking cessation. The secondary prevention measures after ACS were more effective in PHCS users than in SUS users due to better adherence, especially to pharmacotherapy and regular physical activity.
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Affiliation(s)
| | - Danielle Góes da Silva
- Program of Post-Graduation in Nutrition Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Joselina Luzia Meneses Oliveira
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Department of Medicine, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- São Lucas Clinic and Hospital / Rede D Or São Luiz, Aracaju, Sergipe, Brazil
- Division of Cardiology, University Hospital, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - José Rodrigo Santos Silva
- Department of Statistics and Actuarial Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | | | - Luciana Vieira Sousa Alves
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | | | - Juliana de Góes Jorge
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Department of Physiotherapy, Tiradentes University, Aracaju, Sergipe, Brazil
| | | | - Rebeca Rocha de Almeida
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Victor Batista Oliveira
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Larissa Santos Martins
- Program of Post-Graduation in Nutrition Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Jamille Oliveira Costa
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | | | - Silvia Maria Voci
- Program of Post-Graduation in Nutrition Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Marcos Antonio Almeida-Santos
- São Lucas Clinic and Hospital / Rede D Or São Luiz, Aracaju, Sergipe, Brazil
- Postgraduate Program in Health and Environment, Tiradentes University, Aracaju, Sergipe, Brazil
| | - Victoria Vieira Abreu
- Program of Post-Graduation in Nutrition Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Felipe J. Aidar
- Group of Studies and Research in Performance, Sport, Health and Paralympic Sports – GEPEPS, Federal University of Sergipe (UFS), São Cristóvão, Sergipe, Brazil
| | - Leonardo Baumworcel
- São Lucas Clinic and Hospital / Rede D Or São Luiz, Aracaju, Sergipe, Brazil
| | - Antônio Carlos Sobral Sousa
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Department of Medicine, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- São Lucas Clinic and Hospital / Rede D Or São Luiz, Aracaju, Sergipe, Brazil
- Division of Cardiology, University Hospital, Federal University of Sergipe, Aracaju, Sergipe, Brazil
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de Carvalho Costa IMNB, da Silva DG, Oliveira JLM, Silva JRS, de Andrade FA, de Góes Jorge J, de Oliveira LMSM, de Almeida RR, Oliveira VB, Martins LS, Costa JO, de Souza MFC, Pereira LMC, Alves LVS, Voci SM, Almeida-Santos MA, Aidar FJ, Baumworcel L, Sousa ACS. Quality of Life among Patients with Acute Coronary Syndromes Receiving Care from Public and Private Health Care Systems in Brazil. Clin Pract 2022; 12:513-526. [PMID: 35892441 PMCID: PMC9326766 DOI: 10.3390/clinpract12040055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 11/22/2022] Open
Abstract
(1) Background: Quality of life (QOL) is used as a health indicator to assess the effectiveness and impact of therapies in certain groups of patients. This study aimed to analyze the QOL of patients with acute coronary syndrome (ACS) who received medical treatment by a public or private health care system. (2) Methods: This observational, prospective, longitudinal study was carried out in four referral hospitals providing cardiology services in Sergipe, Brazil. QoL was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey. The volunteers were divided into two groups (public or private health care group) according to the type of health care provided. Multiple linear regression models were used to evaluate QoL at 180 days after ACS. (3) Results: A total of 581 patients were eligible, including 44.1% and 55.9% for public and private health care, respectively. At 180 days after ACS, the public health care group had lower QoL scores for all domains (functional capacity, physical aspects, pain, general health status, vitality, social condition, emotional profile, and health) (p < 0.05) than the private group. The highest QoL level was associated with male sex (p < 0.05) and adherence to physical activity (p ≤ 0.003) for all assessed domains. (4) Conclusions: This shows that social factors and health status disparities influence QoL after ACS in Sergipe.
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Affiliation(s)
- Ingrid Maria Novais Barros de Carvalho Costa
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
- Federal Institute of Sergipe, São Cristóvão 49100-000, Brazil
| | - Danielle Góes da Silva
- Department of Nutrition, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (D.G.d.S.); (S.M.V.)
| | - Joselina Luzia Meneses Oliveira
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
- Department of Medicine, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
- São Lucas Clinic and Hospital/Rede D’Or São Luiz, Aracaju 49015-380, Brazil;
- Division of Cardiology, University Hospital, Federal University of Sergipe, Aracaju 49060-025, Brazil
| | - José Rodrigo Santos Silva
- Department of Statistics and Actuarial Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil;
| | | | - Juliana de Góes Jorge
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
| | - Larissa Marina Santana Mendonça de Oliveira
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
| | - Rebeca Rocha de Almeida
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
| | - Victor Batista Oliveira
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
| | - Larissa Santos Martins
- Graduate Program in Nutrition Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil;
| | - Jamille Oliveira Costa
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
| | | | - Larissa Monteiro Costa Pereira
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
| | - Luciana Vieira Sousa Alves
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
| | - Silvia Maria Voci
- Department of Nutrition, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (D.G.d.S.); (S.M.V.)
| | - Marcos Antonio Almeida-Santos
- São Lucas Clinic and Hospital/Rede D’Or São Luiz, Aracaju 49015-380, Brazil;
- Graduate Program in Health and Environment, Tiradentes University, Aracaju 49032-490, Brazil
| | - Felipe J. Aidar
- Group of Studies and Research in Performance, Sport, Health and Paralympic Sports–GEPEPS, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
| | - Leonardo Baumworcel
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
- São Lucas Clinic and Hospital/Rede D’Or São Luiz, Aracaju 49015-380, Brazil;
| | - Antônio Carlos Sobral Sousa
- Graduation Program in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, Brazil; (I.M.N.B.d.C.C.); (J.L.M.O.); (J.d.G.J.); (L.M.S.M.d.O.); (V.B.O.); (J.O.C.); (L.M.C.P.); (L.V.S.A.); (L.B.); (A.C.S.S.)
- Department of Medicine, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
- São Lucas Clinic and Hospital/Rede D’Or São Luiz, Aracaju 49015-380, Brazil;
- Division of Cardiology, University Hospital, Federal University of Sergipe, Aracaju 49060-025, Brazil
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Lovatt S, Wong CW, Holroyd E, Butler R, Phan T, Patwala A, Loke YK, Mallen CD, Kwok CS. Smoking cessation after acute coronary syndrome: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14894. [PMID: 34541754 DOI: 10.1111/ijcp.14894] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/02/2021] [Accepted: 09/17/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Smoking cessation is an effective secondary prevention measure after acute coronary syndrome (ACS). We conducted a systematic review with the aim to better understand which patients have a greater propensity to quit smoking and the risk factors for continued smoking after ACS. METHODS We searched MEDLINE and EMBASE for studies that evaluated smoking cessation after ACS. The pooled rate of smoking cessation across included studies was performed. Random effects meta-analysis for different variables and their association with smoking cessation was conducted. RESULTS A total of 39 studies with 11 228 patients were included in this review. The pooled rate of smoking cessation following ACS across 38 studies was 45.0%. Factors associated with greater likelihood of smoking cessation were attendance at cardiac rehabilitation (OR 1.90 95% CI 1.44-2.51), married/not alone (OR 1.68 95% CI 1.32-2.13), intention/attempt to quit smoking (OR 1.27 95% CI 1.11-1.46), diabetes mellitus (OR 1.24 95% CI 1.03-1.51) and hospitalised duration (OR 1.09 95% CI 1.02-1.15). Variables associated with a lower likelihood of smoking cessation were depression (OR 0.57 95% CI 0.43-0.75), chronic obstructive pulmonary disease/lung disease (OR 0.73 95% CI 0.57-0.93), previous admission with acute myocardial infarction/cardiac admission (OR 0.61 95% CI 0.47-0.80), cerebrovascular disease/transient ischaemic attack (OR 0.42 95% CI 0.30-0.58) and unemployment (OR 0.37 95% CI 0.17-0.80). CONCLUSIONS The majority of smokers with an ACS continue to smoke after admission. Patients attending cardiac rehabilitation show increased odds of quitting while people who are depressed and those with chronic lung disease were less likely to quit smoking and should be targeted for intensive smoking cessation interventions.
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Affiliation(s)
- Saul Lovatt
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Chun Wai Wong
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Eric Holroyd
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Rob Butler
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Thanh Phan
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Ashish Patwala
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Yoon K Loke
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Chun Shing Kwok
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
- School of Medicine, Keele University, Stoke-on-Trent, UK
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Hanif M, Mirza E, Khan MA, Ahmad SW, Little C. Long-term mortality and living arrangements in acute coronary syndrome treated with percutaneous coronary intervention. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2020; 6:339. [PMID: 32259200 DOI: 10.1093/ehjqcco/qcaa024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/24/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Moghees Hanif
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Eushaa Mirza
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Muhammad Asad Khan
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sa'ad Wajih Ahmad
- Department of General Surgery, Scunthorpe General Hospital, Northern Lincolnshire and Goole Trust, London, UK
| | - Callum Little
- Department of Cardiology, Royal Free London NHS Foundation Trust, London, UK
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