Document Type : Original Quantitative and Qualitative Research Paper
Authors
1
Student Research Committee, faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad,Iran
2
Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3
Department of Cardiology, School of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
4
Assistant Professor of Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/ebcj.2025.87319.3119
Abstract
Background: Acute Coronary Syndrome (ACS) is a major global cause of morbidity and mortality, requiring consistent treatment adherence. However, maintaining adherence to diet, physical activity, and medication is challenging. The Transitional Care Pathway (TCP) is a structured intervention that provides personalized education, follow-up calls, and lifestyle planning to support patients during the critical post-discharge period.
Aim: This study evaluated the effectiveness of TCP in improving treatment adherence among ACS patients.
Method: In this 2024 randomized controlled trial (IRCT20220130053882N2) at Imam Reza Hospital, Mashhad, Iran, 79 patients were randomly assigned to the intervention group (n=39; TCP-based education and follow-up) or the control group (n=40; standard oral instructions and pamphlets) using time-block randomization. The allocation sequence, generated via Randomizer.org, was concealed in eight opaque envelopes, opened weekly. Adherence was assessed using Ziaei’s Treatment Adherence Questionnaire at baseline and one month post-discharge.
Results: In the intervention group, the mean age of patients was 57.43 ± 14.31 years, while in the control group, it was 57.48 ± 12.19 years. Pre-intervention mean adherence scores were 49.56 ± 14.24 (intervention) and 49.63 ± 12.75 (control) (P=0.984). Post-intervention scores increased to 66.97 ± 10.78 and 60.03 ± 12.16, respectively (P=0.009). Both groups showed significant within-group improvements (P<0.001), particularly in dietary (P=0.012) and physical activity adherence (P=0.012), while medication adherence showed no significant between-group difference (P=0.308).
Implications for Practice: Integrating TCP into routine care may enhance adherence to non-pharmacologic regimens and improve long-term outcomes in ACS patients. Given the short one-month follow-up, longer-term studies are recommended.
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