[Returning to work after an acute coronary syndrome: When waiting is wasting].
BACKGROUND
Return to work (RTW) after acute coronary syndrome (ACS) is an important issue for the patient's future.


OBJECTIVE
The study aim was to determine whether RTW practice complies with guidelines or is delayed by failure in patient management. We analysed the factors influencing RTW beyond the 90-day period recommended by guidelines.


METHODS
We conducted a survey of 216 self-employed workers admitted to the hospital for ACS using self-report questionnaires and medical examination. Factors influencing RTW, occupational and cardiac features, and recall and source of medical information were investigated.


RESULTS
Ninety-three of 216 patients did not return to work by 90 days, despite good cardiac performance in 30 cases (32 %). The mean sick leave duration was 93.3±103.7 days. Advice concerning return to work was completely missing for 44 % of patients. Cardiac performance was independent of sick leave duration, but was correlated with the likelihood of RTW (P<0.001). Patients assimilated about 70 % of the medical information they were provided, but only 53 % of work-related information. Recall of work-related information was better among patients admitted to a rehabilitation facility (65 %) compared to those who did not receive rehabilitation (P<0.05).


CONCLUSIONS
Cardiologists should assess the patient's cardiac performance within 2 months after ACS. Patient management should also include cardiac rehabilitation or therapeutic education toward improving information recall.
Service médical du RSI, 139, rue de Saussure, 75017 Paris, France. Electronic address: francois.latil@rsi.fr.
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Latil
Service de réadaptation cardiaque, hôpital Corentin-Celton, 92130 Issy-les-Moulineaux, France.
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Iliou
Service médical du RSI, 139, rue de Saussure, 75017 Paris, France.
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Boileau
Service médical du RSI, 139, rue de Saussure, 75017 Paris, France.
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Pietri
Service médical du RSI, 139, rue de Saussure, 75017 Paris, France.
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Lechien
Service médical du RSI, 139, rue de Saussure, 75017 Paris, France.
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Ha-Vinh
Service médical du RSI, 139, rue de Saussure, 75017 Paris, France.
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Guimond
D054058:Acute Coronary Syndrome / Q000453:epidemiology; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062707:Return to Work / Q000706:statistics & numerical data; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors
Acute coronary syndrome; Arrêt de travail; Conditions de travail; Critical pathways; Health organisation; Information en santé; Maladie coronaire; Return to work; Réadaptation professionnelle; Therapeutic education as a topic