Association of patient-reported psychosocial healthcare and risk of readmissions and mortality in patients with ischemic heart disease: A population-based cohort study

Line Zinckernagel, Teresa Holmberg, Ann Dorthe Olsen Zwisler, Susanne S. Pedersen, Christina Boesgaard Graversen, Annette Kjær Ersbøll

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Abstrakt

Objective
Psychosocial risk factors are common in patients with ischemic heart disease (IHD) and linked to poor prognosis. Psychosocial healthcare is recommended in international guidelines and has demonstrated positive effects, primarily on psychosocial symptoms. We examined the association between patient-reported psychosocial healthcare and hospital readmissions and mortality in patients with IHD.
Methods
A population-based cohort study with register-based follow-up. Patient-reported psychosocial healthcare was measured by seven items in a survey sent to a random sample of patients with incident IHD in Denmark in 2014. We used multivariable Cox proportional hazards models and Poisson regression to examine the association between psychosocial healthcare and readmissions and all-cause mortality.
Results
In total, 1083 (57%) patients were followed up to 4½ years. Low psychosocial support was reported by 53.4%, medium by 26.2% and high by 20.4% patients. The hazard of acute cardiac readmission for patients reporting low psychosocial healthcare was 2.08 higher than for patients reporting high psychosocial healthcare (95%CI:1.01–4.30). No association was found with time to first all-cause readmission. The acute cardiac readmission rate was 3.24 (95%CI:1.66–6.29) and 4.23 (95%CI:2.15–8.33) times higher among patients reporting low and medium psychosocial healthcare compared to high, and the all-cause readmission rate was 1.30 (95%CI:1.16–1.46) and 1.32 (95%CI:1.17–1.49) times higher. The hazard of death was 2.86 (95%CI:1.23–6.69) and 2.88 (95%CI:1.18–7.04) times higher among patients reporting low and medium psychosocial healthcare compared to high.
Conclusion
In patients with IHD, a high level of patient-reported psychosocial healthcare was significantly associated with reduced hospital readmissions and all-cause mortality.
OriginalsprogEngelsk
Artikelnummer 110776
TidsskriftJournal of Psychosomatic Research
Vol/bind156
Udgave nummerMay
ISSN0022-3999
DOI
StatusUdgivet - mar. 2022

Bibliografisk note

Funding Information:
This work was supported by The Danish Heart Foundation [grant number 15-R99-A5908-22941 ]. The funding source had no involvement in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2022 The Authors

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