Elderly patients less likely to correctly manage angina symptoms post-PCI
Elderly patients with angina who have undergone percutaneous coronary intervention (PCI) are less likely to correctly manage recurring symptoms than younger patients, thus more effective methods of encouraging proper management in this group of patients is required, according to a poster presented at the recent Singapore Prevention & Cardiac Rehabilitation Symposium 2017 (SPCRS 2017).
“More patients are having PCI to alleviate symptoms [of angina] but post-procedure there is a need for patients to self-manage their coronary heart disease [CHD] by adhering to secondary prevention medicines, adopting healthy lifestyles, and managing any recurring angina symptoms,” said the study authors led by Associate Professor Susan Dawkes from the Edinburgh Napier University, Edinburgh, Scotland, UK.
“There is, however, little evidence of how older patients self-manage their CHD after elective PCI,” said Dawkes and co-authors.
This mixed methods study included 93 patients who were recruited at a follow-up appointment with their cardiologist 3 months after undergoing elective PCI. The study was divided into two phases; phase 1 involved a self-administered survey which was distributed to all participants, while 10 participants were interviewed during phase 2. The findings presented in the poster were that of the subgroup of patients aged ≥65 years (n=47).
Of the elderly patients, 78.7 percent (n=37) reported that they managed their recurring symptoms by taking glyceryl trinitrate, while 34 percent (n=16) opted for rest to alleviate their symptoms. About 28 percent (n=13) reported that they would seek help from their general practitioner (GP), regardless of symptom duration or severity. [SPCRS 2017, poster N-29]
While older patients were less likely to smoke (p=0.01) and weighed less than their younger counterparts (p=0.02), age did not appear to affect the likelihood of patients modifying their diet (p=0.237), though older patients with comorbidities were less likely to practise lifestyle modifications.
All participants reported being treatment adherent, though many were unaware of the purpose of their medications.
“Older people were more stoical and would delay seeking help for prolonged episodes of angina which may affect their morbidity and mortality,” said Dawkes and co-authors. “They had a greater reliance on their GP to help them deal with symptoms and they often trivialized their angina symptoms.”
“It seems that current methods of supporting older patients in their CHD self-management are ineffective and alternative methods must be identified. [F]urther research is needed to determine the most effective method of supporting older patients in their CHD self-management after PCI,” said the authors.