Self-Management Support for Acute Coronary Syndrome Patients After Hospital Discharge (ACS)
September 2, 2026 updated by: Nanfang Hospital, Southern Medical University
Construction and Empirical Study of a "Hospital-to-Home" Self-Management Support Model for ACS Patients Based on the Integrated COM-B and HAPA Models
This randomized controlled trial evaluates a "Hospital-to-Home" self-management support model for Acute Coronary Syndrome (ACS) patients, which is based on the integrated COM-B and HAPA theories.
Participants are randomly assigned to either an intervention group receiving a structured self-management program or a control group receiving standard education.
The study compares self-management behaviors and health outcomes between the two groups to assess the model's effectiveness.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
80
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Department of Cardiology, Nanfang Hospital
- Phone Number: 020-62707277
- Email: 243206095@qq.com
Study Locations
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Guangdong
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Guangzhou, Guangdong, China, 510515
- Nanfang Hospital, Southern Medical University
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Contact:
- Department of Cardiology, Nanfang Hospital
- Phone Number: 020-62707277
- Email: 243206095@qq.com
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Diagnosed with acute coronary syndrome (ACS) according to the Guidelines for the Rapid Emergency Diagnosis and Treatment of Acute Coronary Syndrome (2019), based on electrocardiogram (ECG), serological tests, and symptomatology.
- Age ≥ 18 years.
- Mentally alert, with unimpaired communication skills, and adequate reading and expressive abilities.
- Patient, or their primary caregiver, able to use the study communication tool (WeChat).
Exclusion Criteria:
- Advanced or terminal stage of disease with expected survival less than 12 months.
- Severe physical comorbidities (e.g., decompensated cardiac, hepatic, or renal function).
- Motor dysfunction or mobility impairment.
- Currently participating in or previously participated in a similar clinical study.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Intervention Group
Participants receive the structured self-management support program based on the integrated COM-B and HAPA models, including enhanced education and follow-up support.
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This intervention is based on the integrated HAPA and COM-B models.
Using HAPA, patients are categorized into three phases: pre-action (contemplation), action initiation (early post-discharge), and behavior maintenance (≥1 month post-discharge).
Prior to discharge, a COM-B assessment identifies individual barriers and facilitators across capability, opportunity, and motivation.
Tailored self-management support is then delivered according to the patient's phase and COM-B profile.
The core intervention consists of one in-depth inpatient interview and three outpatient sessions for self-management planning, execution, and confirmation.
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Active Comparator: Control Group
Participants receive standard care and routine health education.
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Participants receive routine health education and standard care according to the hospital's standard clinical pathway for ACS patients.
This includes basic discharge instructions, brochures on heart-healthy lifestyles, and routine outpatient follow-up appointments.
No additional structured self-management support or extra telephone follow-ups are provided beyond standard care.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Heart Health Self-Efficacy and Self-Management Scale (HHSES) score
Time Frame: At baseline and at 13, 36, and 60 weeks of follow-up.
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The Heart Health Self-Efficacy and Self-Management Scale (HHSES) is a 12-item instrument assessing participants' self-efficacy and self-management behaviors.
Total scores range from 12 (minimum) to 48 (maximum), with higher scores indicating better self-efficacy and self-management.
Scores ≥36 indicate high self-efficacy and self-management; 25-35 indicate a moderate level; and ≤24 indicate a low level.
Administered at baseline and at 13, 36, and 60 weeks of follow-up.
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At baseline and at 13, 36, and 60 weeks of follow-up.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of major adverse cardiovascular events (MACE) including heart failure, angina, arrhythmia, and recurrent myocardial infarction
Time Frame: From the end of treatment through 60 weeks of follow-up
|
Major adverse cardiovascular events (MACE) is a composite outcome defined as the occurrence of heart failure, angina, arrhythmia, or recurrent myocardial infarction.
Reported as number and proportion of participants experiencing any component event and/or the composite MACE.
Assessed from the end of treatment through 60 weeks of follow-up.
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From the end of treatment through 60 weeks of follow-up
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Emergency department visit rate for cardiac-related reasons
Time Frame: From the end of treatment through 60 weeks of follow-up
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Proportion of participants with emergency department visits for cardiac-related reasons during the follow-up period.
Calculated as (number of participants with cardiac-related emergency department visits ÷ total number of eligible participants at start of follow-up) × 100%.
Assessed from the end of treatment through 60 weeks of follow-up.
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From the end of treatment through 60 weeks of follow-up
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Social Support Rating Scale (SSRS) score
Time Frame: At baseline and at 13, 36, and 60 weeks of follow-up
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The Social Support Rating Scale (SSRS) is a 10-item instrument assessing social support along three dimensions: objective support, subjective support, and utilization of social support.
Total scores range from 13 to 70.
Scores < 33 indicate low social support; 33-45 indicate moderate social support; and > 45 indicate high social support.
Assessed at baseline and at 13, 36, and 60 weeks of follow-up.
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At baseline and at 13, 36, and 60 weeks of follow-up
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Chinese Version of the Brief Illness Perception Questionnaire (BIPQ) score
Time Frame: At baseline and at 13, 36, and 60 weeks of follow-up
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The Chinese Version of the Brief Illness Perception Questionnaire (BIPQ) is a 9-item instrument measuring illness perception.
Total scores range from 0 (minimum) to 80 (maximum), with higher scores indicating worse/more negative illness perception (stronger perceived threat or more negative views toward the illness).
Assessed at baseline and at 13, 36, and 60 weeks of follow-up.
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At baseline and at 13, 36, and 60 weeks of follow-up
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Cardiovascular re-hospitalization rate
Time Frame: Assessed from the end of treatment through 60 weeks of follow-up.
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Proportion of participants re-hospitalized for cardiovascular reasons (e.g., heart failure, angina, arrhythmia, recurrent myocardial infarction) during the 12-month period after the end of treatment.
Calculated as (number of participants re-hospitalized for ACS-related cardiovascular reasons during the follow-up period ÷ total number of eligible patients at the start of the follow-up period) × 100%.
Assessed from the end of treatment through 60 weeks of follow-up.
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Assessed from the end of treatment through 60 weeks of follow-up.
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Medication Adherence Report Scale (MARS-10) score
Time Frame: Assessed at 13, 36, and 60 weeks of follow-up.
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The Medication Adherence Report Scale (MARS-10) is a 10-item self-report questionnaire using a dichotomous yes/no response format.
It evaluates medication adherence across three dimensions: medication adherence behavior, attitude toward taking medication, and negative side effects and attitudes toward medication.
Total scores range from 0 to 10.
A score ≤ 5 indicates medication non-adherence, and a score ≥ 6 indicates medication adherence.
Assessed at 13, 36, and 60 weeks of follow-up.
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Assessed at 13, 36, and 60 weeks of follow-up.
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Estimated)
September 1, 2026
Primary Completion (Estimated)
December 1, 2027
Study Completion (Estimated)
December 1, 2028
Study Registration Dates
First Submitted
August 18, 2026
First Submitted That Met QC Criteria
August 30, 2026
First Posted (Actual)
September 2, 2026
Study Record Updates
Last Update Posted (Actual)
September 4, 2026
Last Update Submitted That Met QC Criteria
September 2, 2026
Last Verified
September 1, 2026
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- NFEC-2026-428
- 2025CR031 (Other Grant/Funding Number: 2025 Nanfang Hospital of South)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
De-identified individual participant data (IPD) including baseline characteristics, intervention implementation data, and primary and secondary outcome measures will be shared.
The data sharing plan has been approved by the institutional ethics committee and included in the informed consent process.
IPD Sharing Time Frame
Data will be available starting from 6 months after the publication of the main results and will remain accessible for a period of 3 years.
IPD Sharing Access Criteria
Access will be granted to qualified researchers (clinicians and nursing scientists) who propose to use the data for legitimate scientific purposes.
Interested researchers can submit a data request to the Principal Investigator via email.
A data use agreement must be signed prior to data access.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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