Follow-Up of Post Myocardial Infarction Using Telemedicine: Stakeholders’ Education, Results and Customer Satisfaction.

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Background. There are few studies about post myocardial infarction follow-up using telemedicine. We organized a post-discharge telemedicine service with a dedicated team. To do this, it was necessary that all stakeholders involved in the organization and use of the telemedicine service were properly educated and informed. Methods. We designed a theoretical-practical mini-course, to train healthcare personnel and increase skills, with excellent learning outcomes and satisfaction. Thereafter, we enrolled patients affected by acute myocardial infarction with ST elevation (STEMI), MINOCA (myocardial infarction with no obstructive coronary atherosclerosis), Takotsubo syndrome or spontaneous coronary dissection, and high-risk acute myocardial infarction without ST elevation (NSTEMI). At discharge, the cardiology technician performed counselling for the patient; using regional platforms, televisit at 1 and 4 months monitored major adverse cardiac events (MACE), heart failure, arrhythmias, unstable angina and non-cardiovascular events, therapy adherence, target therapy and customer satisfaction. Results. Between November 2021 and February 2023, we enrolled 110 patients: 72% affected by STEMI, 22% by NSTEMI. At the 1-month follow up, 12 patients did not reach pressure target and 23 patients did not reach LDL target. We observed three in hospital readmission, three in hospital visits for further investigation and one death. To date, a four months follow up was performed for 54 patients. No readmissions or deaths occurred. We detect a rate of 96% of customer satisfaction. Conclusion. A health coordination center with a dedicated team makes televisit safe as a follow-up for post myocardial infarction patients. Before, it is fundamental for healthcare professionals the acquisition of theoretical knowledge and updates and the acquisition of manual, technical and practical skills.

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