Effects of a multidisciplinary transitional care programme on self-management and quality of life in patients undergoing percutaneous coronary intervention: a propensity score-matched analysis

OBJECTIVES: Adequate self-management support following percutaneous coronary intervention (PCI) remains a recognised challenge. This study evaluated the Integrated Psychocardiology Transitional Care (IPTC) programme's effect on self-management and quality of life, and the mechanism of their interaction. DESIGN: Retrospective cohort study. PARTICIPANTS: Outcomes were analysed for 697 patients after propensity score matching from an initial PCI registry cohort of 1148. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was change in Coronary Artery Disease Self-Management Scale Score over 12 months. Secondary outcomes included the Seattle Angina Questionnaire (SAQ), 36-Item Short Form Health Survey (SF-36), Generalised Anxiety Disorder 7 and Patient Health Questionnaire 9 scores. Mixed-effects models and time-lagged mediation analysis were used to examine longitudinal changes and the mediating role of self-management. RESULTS: No between-group difference in self-management was observed at 1 month. Significant differences in self-management emerged at 3 months, 6 months and 12 months (all p<0.001). The mixed-effects model for repeated measures analysis revealed significant group × time interaction effects (F=183.1, p<0.001), indicating differential improvement trajectories favouring the IPTC group. The IPTC group showed significantly better SF-36 physical (45.6±9.6 vs 39.8±8.4, 95% CI 4.5 to 7.2, p<0.001) and mental (44.9±8.3 vs 41.7±8.1, 95% CI 2.0 to 4.4, p<0.001) scores at 12 months. Time-lagged mediation analysis confirmed self-management improvement mediated quality of life effects. CONCLUSIONS: The IPTC programme is associated with improved quality of life in PCI patients, and this association appears to be partly explained by enhanced self-management. These findings suggest that integrating psychology-informed transitional care into post-PCI care may be beneficial.