Enhancing Post-Discharge Care for People Who Have Had an Acute Myocardial Infarction in Portugal: Insights From...

Cardiovascular disease is the leading cause of death and disability, with the post-discharge period being particularly vulnerable for patients due to communication issues, medication errors, and inadequate follow-up. This study explores the patient experience following acute myocardial infarction in the Portuguese healthcare system, providing insights to improve care quality, outcomes, and satisfaction.

This study used qualitative patient journey mapping through semi-structured telephone interviews with people who have had an acute myocardial infarction discharged between January and December 2023, to explore their experiences, identify areas for improvement in the Portuguese healthcare system, and develop patient-centred solutions. To complement self-reported data, data were collected from patients' electronic health records.

While participants were generally satisfied with the care provided during hospitalisation and discharge, significant gaps were identified, such as no shared decision-making on goal setting, limited medication counselling, insufficient coordination with Primary Health Care (PHC), and delays in hospital follow-up beyond European Society of Cardiology guideline recommendations. Many patients had limited follow-up in PHC, with follow-up appointments often relying on patient initiative, and long waiting times for hospital follow-up care. By combining patient narratives with electronic health records and multidisciplinary validation, the findings underscore the need for a more integrated and patient-centred approach.

Post-acute myocardial infarction care in Portugal shows critical gaps in discharge planning, PHC coordination, and timely follow-up. Strengthening patient-centred strategies, including structured protocols, systematic use of Patient-Reported Outcome and Experience Measures, earlier and nurse-led PHC follow-up, and stronger coordination across care levels, are essential to enhance recovery, reduce readmissions, and improve long-term outcomes.

Data were analysed by a multidisciplinary team, which included two patient representatives with lived experience of myocardial infarction, to ensure that the findings reflect both clinical perspectives and patient priorities.