Effect of continuity of care on medication adherence and psychological outcomes in patients with coronary heart disease: a retrospective cohort study

Background Coronary heart disease (CHD) is a prevalent cardiovascular disorder worldwide. Post-discharge medication non-adherence and high anxiety/depression rates often lead to disease recurrence and reduced quality of life in CHD patients. While continuity of care is hypothesized to improve these outcomes, existing evidence is limited by high heterogeneity and lack of large-sample standardized validation in CHD populations. Objective This study aimed to assess the effects of continuity of care on medication adherence, psychological status, and cardiovascular readmission rates in post-discharge CHD patients. Methods A total of 320 CHD patients discharged between January 2021 and June 2023 were divided into an intervention group (structured continuity of care) and a conventional care group. We adopted 1:1 propensity score matching to control baseline confounders, with 128 patients per group included in the final analysis. The primary outcome was 6-month medication adherence measured by Medication Possession Ratio (MPR). Secondary outcomes included Hospital Anxiety and Depression Scale (HADS) scores and cardiovascular readmission rates. Results Post-matching, the two groups were well-balanced in baseline characteristics. The intervention group showed significantly higher 6-month MPR (86.3 ± 9.7% vs. 67.5 ± 11.3%; MD = 18.8%, 95% CI: 16.1%–21.5%) and a greater proportion of good adherence (82.0% vs. 53.9%; RR = 1.52, 95% CI: 1.31–1.77). HADS anxiety and depression scores were notably lower in the intervention group (anxiety: 6.1 ± 2.2 vs. 9.0 ± 2.6; depression: 5.7 ± 2.4 vs. 8.6 ± 2.8). The 6-month cardiovascular readmission rate was significantly reduced in the intervention group (5.5% vs. 16.4%; RR = 0.33, 95% CI: 0.15–0.72). Conclusion Continuity of care is associated with improved long-term medication adherence, alleviated anxiety and depression, and reduced cardiovascular readmission risk in post-discharge CHD patients. It is recommended to gradually incorporate it into the routine management of cardiovascular disease rehabilitation after its efficacy has been validated in multicenter studies.