Impact of continuous home care on quality of life and depression status in patients with acute coronary syndrome.

OBJECTIVE: Our aim in this study is to evaluate the impact of continuous home-based care on depressive symptoms, quality of life, and major adverse cardiovascular events in patients with acute coronary syndrome (ACS) and mild-to-moderate depression.

METHODS: A total of 200 patients with ACS diagnosed in our hospital during the period between October 2021 and April 2024 were selected for the study. All patients were screened for depression using the PHQ-9 questionnaire 1-8 weeks after myocardial infarction. Patients with scores consistent with mild to moderate depression were included in the study. After baseline assessment, eligible participants were randomly assigned 1:1 to the routine care group or the continuous home care group using a computer-generated block-randomization sequence, stratified by depression severity and ACS type. Depression, quality of life, and adverse cardiovascular events in the two groups of patients at different time points were analyzed.

RESULTS: There were no statistical differences in clinical data and background between the two groups of patients included in the study (P > 0.05). However, as the follow-up time prolonged, the anxiety and depression scores of patients in the continuous home care group were significantly lower than those in the routine care group (EQOL-VAS score at 6 months' follow-up: routine care group 70.31 ± 7.77, continuous home care group 79.69 ± 6.07, P = 0.043; EQOL-VAS score at 12 months' follow-up: routine care group 63.82 ± 6.73, continuous home care group 74.42 ± 7.24, P = 0.046; EQOL-VAS score at 18 months' follow-up: routine care group 54.15 ± 13.30, continuous home care group 63.94 ± 11.28, P = 0.038). In addition, compared with the routine care group, the quality of life of patients in the continuous home care group significantly improved, and the overall incidence of adverse cardiovascular events was lower (P < 0.05) in this group than in the former group.

CONCLUSIONS: The results of the study showed that continuous home care can alleviate the anxiety and depression of patients with ACS, enhance their quality of life, reduce the incidence of adverse cardiovascular events, and improve their prognosis. After adjusting for confounding factors such as age, history of MI, heart failure, and medication adherence, the intervention effect did not show significant attenuation, further confirming its independent protective role.