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Original Research: Telephone Follow-Up for Patients After Myocardial Revascularization A Systematic Review

Furuya, Rejane K. RN; Mata, Luciana R. F. MSc, RN; Veras, Vivian S. MSc, RN; Appoloni, Aline H. MSc, RN; Dantas, Rosana A. S. PhD, RN; Silveira, Renata C. C. P. PhD, RN; Rossi, Lidia A. PhD, RN

AJN The American Journal of Nursing: May 2013 - Volume 113 - Issue 5 - p 28–31
doi: 10.1097/
Feature Articles

Objective To identify studies of telephone follow-up conducted with patients who had undergone myocardial revascularization, and to assess and synthesize the results.

Design and methods This is a systematic review; the literature search was conducted in six electronic databases. Controlled descriptors were health education, teaching, myocardial revascularization, coronary artery bypass, angioplasty, telenursing, telephone, and hotlines; the noncontrolled descriptor was needs information. Of 170 identified studies, seven met the inclusion criteria and were selected for analysis. The Jadad scale, which ranges from 0 to 5, was used to assess the methodological quality of studies, with scores of 3 to 5 indicative of higher quality.

Findings Five of the seven studies found statistically significant positive changes in the outcome measures of health-related quality of life, pain, physical functioning, mood symptoms, anxiety, knowledge about self-care measures, medication compliance, and the lipid profile. Four of these five studies had a Jadad score of 3 and were of higher quality.

Conclusions This review provides nurses and other clinicians with a synthesis of research on telephone follow-up in patients after myocardial revascularization. Of the seven studies analyzed, five showed evidence of some benefit from telephone follow-up. Their findings support the use of telephone follow-up to periodically assess patient knowledge, discuss patient concerns and offer ways to address them, monitor mood symptoms and anxiety levels, and encourage behavioral and lifestyle changes. Although any telephone follow-up intervention must be adapted according to each patient's needs, the lack of similarity among and specific information about the interventions described in the analyzed studies made it difficult to evaluate specific elements. More research is needed to identify optimal content and frequency, number, and duration of calls.

Findings from this systematic review support the use of a telephone follow-up intervention after hospital discharge to assess patient knowledge, discuss patient concerns, and encourage behavioral and lifestyle changes.

Rejane K. Furuya, Luciana R. F. Mata, Vivian S. Veras, and Aline H. Appoloni are doctoral candidates at the College of Nursing, University of São Paulo, Ribeirão Preto, Brazil, where Rosana A. S. Dantas is an associate professor, Renata C. C. P. Silveira is an assistant professor, and Lidia A. Rossi is a full professor in the Department of General and Specialized Nursing. At the time of this study, Aline H. Appoloni was a master's candidate in the graduate nursing program at the Federal University of São Carlos, São Carlos, Brazil. This study was sponsored by an unrestricted educational grant from the São Paulo Research Foundation. Contact author: Lidia A. Rossi, The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

© 2013 Lippincott Williams & Wilkins, Inc.