Does a telephone follow-up intervention for patients discharged with acute myocardial infarction have long-term effects on health-related quality of life? A randomised controlled trial

Aims. An earlier combined proactive and reactive telephone follow‐up intervention for acute myocardial infarction patients after discharge from hospital showed positive effects after six months. The aim of the present study was to assess whether the intervention has long‐term effects up to 18 months after discharge. Design. A prospective randomised controlled trial with 18 months follow‐up. Method. The trial was conducted with 288 patients allocated to a telephone follow‐up intervention group (n = 156) or control group (n = 132). The primary endpoint was health‐related quality of life using the SF‐36. Secondary endpoints included smoking and exercise habits, return to work and rehospitalisation due to chest pain. Results. There were significant improvements over time on most dimensions of health‐related quality of life in both the intervention and control group to US norm population levels on most SF‐36 dimensions and summary scores. The intervention group showed no overall significant improvement beyond six months in the physical or mental summary scores, but there was a significant effect for those aged 70 or above. Although there was a promising effect for rehospitalisation due to chest pain, no significant differences were found between the groups on the secondary endpoints after six months. Conclusion. This study demonstrated that despite positive short‐term effects at six months, the telephone follow‐up intervention had no long‐term effects on health‐related quality of life or secondary endpoints. However, the potential for improvement beyond six months was less than anticipated reflecting a reduced morbidity among acute myocardial infarction patients. Relevance to clinical practice. Telephone follow‐up after discharge from hospital is an easy implementable follow‐up intervention enabling individualised provision of information and support in a time often experienced as stressful by patients. Our study indicates that six months is an adequate support period. Despite positive results six months after discharge no significant added long‐term effects of telephone follow‐up, compared to usual care were found in this study.