Stent card inadequate for patient education after PCI
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Since the beginning of stent use, patients have received a “stent card” after PCI with information about their stent, but a study presented at the American College of Cardiology Scientific Session suggests it is not very useful.
Most patients with stents use cellphones, so an app with stent information may be a better idea, Jordan G. Safirstein, MD, FACC, FSCAI, director of transradial intervention at Morristown Medical Center in New Jersey, told Healio.
“We do so much on our phone, and it makes no sense to me, despite all the progress we have made in refining stents, we still provide patients at the end of the procedure with the same paper card they have gotten since” stents were invented, Safirstein said during an interview. “Nowadays, it’s almost an afterthought. With patients being much more engaged in their care and devices becoming more powerful and taking a larger role in everyday life, it makes sense for patients to know what is implanted in their body. If a patient comes in with in-stent restenosis and is asked what was the last stent they had, they could find out by opening an app.
“We also get calls to our office about whether a stent is MRI-safe,” he said. “On that card in the fine print, it typically says something about MRI safety of coronary stents. It would be a lot easier if that was on their phone, then they could just show the doctor.”
Safirstein and colleagues surveyed 313 patients who underwent PCI with a stent (mean age, 67 years; 24% women; median time from last procedure, 4 years) about retention of the stent card, knowledge of stent information and whether they carried a cellphone.
Only 47.7% of patients had their stent card at the time of the survey, and only 11.4% were able to correctly identify the date, vessel and type of stent, according to the researchers.
Patients with the card were more than twice as likely to correctly identify the vessel stented than patients without the card (OR = 2.5; 95% CI, 1.45-4.1276; P = .001). Increased age and time from PCI were negatively correlated with likelihood of providing correct stent information.
“I was surprised by the inability of the stent card to provide meaningful information,” Safirstein told Healio. “I thought if they had their stent card, they would be able to read off of it and tell the date, type of stent and vessel. Even more disappointing and more supportive of the fact that we need something else, the majority of time, even with the stent card in their hands, patients could not answer basic questions about their stents.”
However, 88.2% of patients had their cellphone with them at the time of taking the survey and 74.5% said they would be willing to use it to store medical information.
“If you exclude our octogenarian population, more than 90% of patients aged 79 and under always had their phones, regardless of where we surveyed them,” Safirstein said in an interview.
The results suggest “we should create a basic mobile app, with the stent card information but maybe a little bit better, and perhaps partner with industry to provide patients with necessary information,” he said. “Perhaps through that app patients could also learn about the medications and secondary prevention measures they need. Maybe it could include a reminder that it has been a year since their stent was put in and maybe they could talk to their doctor about stopping one of their antiplatelet agents. This could provide patients and industry with a mutually beneficial line of communication, all at the discretion of the patient.”
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Safirstein JG, et al. Coronary Intervention: Bifurcations, Bridges and Risk Assessment. Presented at: American College of Cardiology Scientific Session; May 15-17, 2021 (virtual meeting).
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