Strengthening Transitions in Care for Patients with ST-Elevation Myocardial Infarction: A Theory-Based Qualitative
Jacob Crawshaw1,2,3, Marija Corovic1,2, Muhammad Ajlan2
1Centre for Evidence-Based Implementation, Hamilton Health Sciences, Hamilton, Ontario, Canada.
CJC Open
|April 20, 2026
Summary
Improving care transitions after ST-elevation myocardial infarction (STEMI) requires addressing patient knowledge gaps and logistical barriers. Enhanced communication and structured follow-up systems are key to strengthening secondary prevention and improving patient outcomes.
Area of Science:
- Cardiology
- Health Services Research
- Implementation Science
Background:
- Secondary prevention adherence post-ST-elevation myocardial infarction (STEMI) is suboptimal.
- Fragmented care transitions hinder recovery and self-management.
- Regional systems often lack standardized post-STEMI follow-up care.
Purpose of the Study:
- To examine barriers and enablers to post-STEMI care transitions.
- To identify strategies for improving adherence to secondary prevention.
- To inform the development of standardized follow-up systems.
Main Methods:
- Qualitative study using semi-structured interviews with STEMI patients, healthcare providers, and system leaders.
- Theoretical Domains Framework (TDF) and Consolidated Framework for Implementation Research (CFIR) informed interview guides.
- Directed content analysis of interview data.
Main Results:
- Patient barriers included knowledge gaps, difficulty maintaining routines, and logistical challenges.
- Provider/leader barriers involved poor inter-setting communication, limited planning, and funding issues.
- Enablers included social support, expanded roles for advanced practitioners, and virtual care openness.
Conclusions:
- Multilevel barriers and enablers to post-STEMI follow-up were identified using behavioral and implementation frameworks.
- Structured education, interdisciplinary collaboration, and expanded non-physician roles can improve secondary prevention.
- Targeted strategies are essential for strengthening post-STEMI care transitions and patient outcomes.
Keywords:
care coordinationcontinuity of careimplementation sciencemultidisciplinary teamspatient engagementtransitional careMore Related Videos
09:52Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
18.1K
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
4.8K
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
01:30Acute Coronary Syndrome I: Introduction
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
01:28Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
01:26Acute Coronary Syndrome V: Nursing Management
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
01:20Angina V: Nursing Management
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...