Effect of an Educational Intervention on Health-Related Quality of Life in Patients With Acute Coronary Syndrome: A Non-randomized Clinical Trial

Introduction Acute coronary syndrome (ACS) is a life-threatening condition that requires long-term management after successful treatment in the acute phase. This study aimed to evaluate the effectiveness of a secondary prevention educational program on health-related quality of life (HRQoL) in patients with acute coronary syndrome (ACS) treated with percutaneous coronary angioplasty (PCI). Methods This non-randomized controlled, single-blinded, two-parallel-group trial included 122 patients who were recruited from the outpatient cardiology clinic of a university hospital in Greece from July 2022 to September 2024 and allocated equally to the intervention or the control group. Intervention group patients received an individual session, guided by a nurse, that combined the use of a structured educational video, brochure, and individual counseling. Control group patients received standard care and the brochure. Data were collected by completing the health survey (SF-36) questionnaire at baseline before the intervention and after six months of follow-up. The statistical analysis included the chi-square test for nominal data and the paired t-test and mixed design repeated measures analysis of variance (ANOVA) for differences within and between groups at different time points. The statistical significance level was p < 0.05. Results No statistically significant differences were found in demographic and clinical scores before intervention between the two groups, confirming equivalence at baseline. Around 111 participants completed the follow-up and were included in the final analysis. Compared to baseline, at the six-month follow-up, both groups recorded statistically significantly improved scores on most dimensions of HRQoL. Using the repeated measures ANOVA test, it was found that the intervention group statistically significantly improved the general health (GH, p=0.023) subscale of HRQoL compared to the control group. Additionally, marginal significance was found in physical functioning (PF, p=0.054) and in role physical (RP, p=0.060). Conclusions This study found a statistically significant positive effect of an educational program, based on educational video and individual counseling, on the HRQoL subscale for general health and marginal significance on physical functioning and physical role. These findings highlight a potential low-cost alternative for implementation in clinical practice, especially in healthcare systems and organizations that do not have organized cardiac rehabilitation programs or are affected by limited resources.