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Adverse Change in Employment Status After Acute Myocardial Infarction
- Source :
- Circulation. Cardiovascular quality and outcomes, vol 11, iss 6
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Background: Inability to resume employment after acute myocardial infarction (MI) has important implications for patients. We sought to assess the prevalence of and outcomes associated with adverse change in employment after MI in a national US cohort. Methods and Results: The TRANSLATE-ACS study (Treatment with Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome) assessed employment status at baseline and 1 year among 9319 patients with MI (mean age, 60.8 years; SD, 11.3; 27.3% women) enrolled at 233 US hospitals. We defined adverse change in employment as patients working at baseline but working less or not working at 1-year post-MI. In multivariable models, we assessed factors associated with adverse change in employment and its association with patient-reported depression, health status, persistence to evidence-based medications prescribed at discharge, and financial hardship affording medications. Half of the patients (51%; n=4730) were employed at the time of MI. By 1 year, 10% (n=492) of these reported an adverse change in employment, with 3% (n=143) working less and 7% (n=349) no longer working (only 27 of 349 reported retirement). Factors significantly associated with adverse change in employment included a number of unplanned readmissions, postdischarge bleeding complications, hypertension, and smoking. At 1 year, patients with an adverse change in employment were more likely to report depression (Patient Health Questionnaire 2 score >3: 27.4% versus 16.7%), lower health status (mean EuroQoL visual analogue scale: 73 [SD, 17.8] versus 78 [SD, 14.8]), and moderate-extreme financial hardship with medication costs (41.0% versus 28.4%; all P Conclusions: Patients who experienced an adverse change in employment after MI reported lower quality of life, increased depression, and more difficulty affording medications. These results underscore the need for interventions to address this patient-centered outcome and its health impact. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01088503.
- Subjects :
- Male
Time Factors
Health Status
Myocardial Infarction
Cardiorespiratory Medicine and Haematology
030204 cardiovascular system & hematology
Cardiovascular
Return to Work
0302 clinical medicine
Cost of Illness
Quality of life
Risk Factors
Absenteeism
adherence
Longitudinal Studies
Registries
030212 general & internal medicine
Myocardial infarction
Depression (differential diagnoses)
Retirement
Depression
Middle Aged
Heart Disease
Mental Health
Treatment Outcome
Public Health and Health Services
medication
Female
Patient Safety
Cardiology and Cardiovascular Medicine
Employment
medicine.medical_specialty
Risk Assessment
Drug Costs
Medication Adherence
03 medical and health sciences
Percutaneous Coronary Intervention
Clinical Research
Behavioral and Social Science
medicine
Humans
Acute Coronary Syndrome
Heart Disease - Coronary Heart Disease
Aged
business.industry
medicine.disease
United States
Good Health and Well Being
quality of life
Cardiovascular System & Hematology
Unemployment
Emergency medicine
Purinergic P2Y Receptor Antagonists
Quality of Life
Health Expenditures
business
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 19417705 and 19417713
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Circulation: Cardiovascular Quality and Outcomes
- Accession number :
- edsair.doi.dedup.....a03c33f9fe52b24444ebd49c300397be