Secondary Preventative Care for Patients After Spontaneous Coronary Artery Dissection: A Qualitative Analysis of Health Care Providers' Perspectives.

Due to their unique demographic, cardiovascular, and psychologic profile, experts recommend that patients with spontaneous coronary artery dissection (SCAD) obtain tailored secondary preventative care. There is a need to glean perspectives from a diverse range of health care providers (eg, cardiology, general practice, and allied health) to supplement existing scientific statements and to delineate providers' current approaches for delivering care. This study qualitatively investigated health care providers' current practices, challenges, and recommendations for delivering secondary preventative care to patients with SCAD. Health care providers (n = 15) from a large cardiac health centre in Canada participated in individual semistructured interviews, which were analyzed with the use of inductive thematic coding techniques. Qualitative data revealed that participants recommend tailored cardiac rehabilitation, acknowledging the "uniqueness" of SCAD, offering provider-facilitated informational and peer support programming, increasing access to psychologic support throughout recovery, and enhancing health care provider education about SCAD. Limited psychologic resources, feasibility of sustaining programs with a small patient population, restrictive thresholds for physical activity, and reassuring patients amid scant evidence-based approaches were cited as major challenges to providing optimal care to patients after SCAD. In conclusion, participants suggest that tailored secondary prevention programming that acknowledges and targets the unique exercise, psychologic, and peer support needs of patients with SCAD, as well as increased education for health care providers, may be integral to promote patients in their recovery.