Association of patient-reported psychosocial healthcare and risk of readmissions and mortality in patients with ischemic heart disease: A population-based cohort study

Line Zinckernagel; Teresa Holmberg; Ann-Dorthe Zwisler; Susanne S Pedersen; Christina B Graversen; Annette K Ersbøll

doi:10.1016/j.jpsychores.2022.110776

Association of patient-reported psychosocial healthcare and risk of readmissions and mortality in patients with ischemic heart disease: A population-based cohort study

J Psychosom Res. 2022 May:156:110776. doi: 10.1016/j.jpsychores.2022.110776. Epub 2022 Mar 3.

Authors

Line Zinckernagel¹, Teresa Holmberg², Ann-Dorthe Zwisler³, Susanne S Pedersen⁴, Christina B Graversen⁵, Annette K Ersbøll⁶

Affiliations

¹ National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. Electronic address: lizi@sdu.dk.
² National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. Electronic address: teho@sdu.dk.
³ REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, and University of Southern Denmark, Nyborg, Denmark. Electronic address: ann.dorthe.olsen.zwisler@rsyd.dk.
⁴ Department of Psychology, University of Southern Denmark, Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark. Electronic address: sspedersen@health.sdu.dk.
⁵ Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. Electronic address: c.graversen@rn.dk.
⁶ National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. Electronic address: ake@sdu.dk.

PMID: 35276588
DOI: 10.1016/j.jpsychores.2022.110776

Abstract

Objective: Psychosocial risk factors are common in patients with ischemic heart disease (IHD) and linked to poor prognosis. Psychosocial healthcare is recommended in international guidelines and has demonstrated positive effects, primarily on psychosocial symptoms. We examined the association between patient-reported psychosocial healthcare and hospital readmissions and mortality in patients with IHD.

Methods: A population-based cohort study with register-based follow-up. Patient-reported psychosocial healthcare was measured by seven items in a survey sent to a random sample of patients with incident IHD in Denmark in 2014. We used multivariable Cox proportional hazards models and Poisson regression to examine the association between psychosocial healthcare and readmissions and all-cause mortality.

Results: In total, 1083 (57%) patients were followed up to 4½ years. Low psychosocial support was reported by 53.4%, medium by 26.2% and high by 20.4% patients. The hazard of acute cardiac readmission for patients reporting low psychosocial healthcare was 2.08 higher than for patients reporting high psychosocial healthcare (95%CI:1.01-4.30). No association was found with time to first all-cause readmission. The acute cardiac readmission rate was 3.24 (95%CI:1.66-6.29) and 4.23 (95%CI:2.15-8.33) times higher among patients reporting low and medium psychosocial healthcare compared to high, and the all-cause readmission rate was 1.30 (95%CI:1.16-1.46) and 1.32 (95%CI:1.17-1.49) times higher. The hazard of death was 2.86 (95%CI:1.23-6.69) and 2.88 (95%CI:1.18-7.04) times higher among patients reporting low and medium psychosocial healthcare compared to high.

Conclusion: In patients with IHD, a high level of patient-reported psychosocial healthcare was significantly associated with reduced hospital readmissions and all-cause mortality.

Keywords: Hospital readmission; Ischemic heart disease; Mortality; Psychosocial factors; Psychosocial healthcare.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Delivery of Health Care
Humans
Myocardial Ischemia* / therapy
Patient Readmission*
Patient Reported Outcome Measures
Risk Factors