Clinical study protocol on assessment of quality of medical care and clinical prognosis in patients who underwent myocardial revascularization accounting modifiable risk factors

Introduction. Every year in Russia, the number of people who have undergone cardiac surgery exceeds 600 thousand. Among them, anemia occurs in 30-70% of cases, and cognitive dysfunction is noted in 20–80% of cases. Anemia increases the risk of death 4-fold within a year, 5-fold the risk of stent thrombosis, 1.3–fold the risk of recurrence of acute coronary syndrome and 2-fold the risk of bleeding, worsens the quality of life, cognitive status and compliance. Unresolved problems of managing medical care for specialized patients are associated with insufficient coupling of components of clinical and sociopsychological interaction, taking into account modifiable risk factors, and irrational use of limited industry resources distributed according to the quota mechanism. Patient-centered digital systems contribute to improving the quality of life of patients, optimizing the use of healthcare resources.

Aim: To evaluate the parameters of the quality of medical care and clinical prognosis in patients who underwent myocardial revascularization, taking into account an expanded range of modifiable risk factors, including anemia, cognitive dysfunction and depression, using a developed digital intelligent data collection system.

Material and Methods. A prospective cohort study of 300 adult patients who underwent myocardial revascularization is planned for 12 months in 3 groups (depending on the consent and technical feasibility of using a digital information system (CIS): 1 group will undergo questionnaires and cognitive behavioral training online through CIS; 2 group will undergo only questionnaires through CIS; 3 group will not use CIS. There are 2 face-to-face visits to the doctor (6 and 12 months), at which the following groups of endpoints will be evaluated: clinical outcomes; parameters of the quality of medical care and rehabilitation; patient-reported experience indicator (PREM). Validated and authored self-questionnaires will be used.

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