Effectiveness of an Intervention to Improve Treatment Adherence and Quality of Life Among Patients After Mechanical Mitral Valve Replacement at the Cardiovascular Center, E Hospital
Main Article Content
Abstract
Objective: To evaluate the effectiveness of an intervention program in improving treatment adherence and quality of life among patients after mechanical mitral valve replacement.
Methods: A pre–post interventional study was conducted at the Cardiovascular Center, E Hospital, from January 2024 to June 2025. One hundred patients with mechanical mitral valve replacement were selected by stratified random sampling from 263 eligible patients and followed for 12 months. The multicomponent intervention included health education and anticoagulation counseling, training in self-monitoring and management skills, INR monitoring and appointment reminders, remote counseling and support, and establishment of patient management records. Treatment adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8), and quality of life was evaluated using the Short Form-36 Health Survey (SF-36).
Results: After 12 months of intervention, the proportion of patients with good treatment adherence increased from 58.0% to 71.0%, while non-adherence decreased from 14.0% to 6.0%; the change was statistically significant (p=0.005). Quality of life improved significantly in seven of the eight SF-36 domains. The greatest improvements were observed in general health, increasing from 61.35 to 72.80 points, and role limitations due to physical health, increasing from 61.75 to 73.00 points. The physical health summary score increased from 72.58 to 79.83, while the mental health summary score increased from 86.43 to 89.19 (p<0.001). The proportion of patients with INR values within the therapeutic range increased from 39.0% at baseline to 60.2% at 12 months.
Conclusion: A 12-month continuous, multicomponent patient-management intervention was effective in improving treatment adherence, quality of life, and anticoagulation control among patients following mechanical mitral valve replacement. Continuous education, self-management support, INR monitoring, follow-up reminders, and remote counseling should be incorporated into the long-term management of these patients.
Keywords
mechanical mitral valve replacement, treatment adherence, quality of life, anticoagulation, international normalized ratio, patient management
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References
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