Development of A structured integrated post-Pulmonary Embolism care model: The Attend-PE model

Area of Science:

• Pulmonary Medicine
• Healthcare Management
• Patient Care Models

Background:

• Over 50% of pulmonary embolism (PE) patients experience lasting functional impairments.
• Current guidelines recommend integrated care for PE, but optimal follow-up strategies lack consensus and sufficient evidence.
• Persistent symptoms significantly impact quality of life for PE survivors.

Purpose of the Study:

• To develop a structured, integrated care model for post-pulmonary embolism (PE) follow-up.
• To utilize coproduction methods, involving patients and healthcare professionals, in model development.
• To create an evidence-based and theoretically grounded follow-up strategy.

Main Methods:

• Employed coproduction and participatory design techniques from October 2021 to June 2022.
• Utilized Intervention Mapping for a stepwise, evidence-based approach.
• Conducted a needs assessment across 18 Danish sites treating PE patients.
• Integrated literature reviews and expert/patient workshops for model design.

Main Results:

• Developed the Attend-PE model, a structured integrated post-PE care pathway.
• Model includes needs assessment, goal definition, and coproduction workshops.
• Attend-PE features in-hospital follow-up, group education, individual consultations, and patient-reported outcomes.
• The model supports personalized post-hospitalization care plans focusing on physical and psychological well-being.

Conclusions:

• Successful coproduction yielded a structured follow-up model meeting patient and provider needs.
• The Attend-PE model aligns with current clinical guidelines.
• The model is undergoing clinical evaluation for effectiveness and usability.