Impact of Transitional Care Pathway on Treatment Adherence in Acute Coronary Syndrome: A Randomized Controlled Trial

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 was conducted with aim to evaluate the effectiveness of TCP in improving treatment adherence among ACS patients.Method: In this randomized controlled trial at Imam Reza Hospital, Mashhad, Iran, ۷۹ patients were randomly assigned to the intervention group (n=۳۹; TCP-based education and follow-up) or the control group (n=۴۰; 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 ۵۷.۴۳ ± ۱۴.۳۱ years, while in the control group, it was ۵۷.۴۸ ± ۱۲.۱۹ years. Pre-intervention mean adherence scores were ۴۹.۵۶ ± ۱۴.۲۴ (intervention) and ۴۹.۶۳ ± ۱۲.۷۵ (control) (p=۰.۹۸۴). Post-intervention scores increased to ۶۶.۹۷ ± ۱۰.۷۸ and ۶۰.۰۳ ± ۱۲.۱۶, respectively (p=۰.۰۰۹). Both groups showed significant within-group improvements (p<۰.۰۰۱), particularly in dietary (p=۰.۰۱۲) and physical activity adherence (p=۰.۰۱۲), while medication adherence showed no significant between-group difference (p=۰.۳۰۸).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.

کلیدواژه ها:

Acute coronary syndrome ، Lifestyle Modification ، Patient Education ، Transitional Care ، treatment adherence