Enhancing quality of life in reflex syncope patients: efficacy of a structured educational programme

Abstract Introduction Reflex syncope (SR) is a prevalent clinical condition that significantly impairs patients’ quality of life (QoL) and imposes substantial economic burdens on healthcare systems. Recurrent syncope episodes often lead to frequent emergency department visits and hospital admissions, escalating healthcare costs and adversely affecting patients’ daily activities and psychological well-being. Despite recommendations for non-pharmacological interventions – such as patient education, lifestyle modifications, and reassurance – there remains a lack of structured educational programmes specifically tailored to RS patients, underscoring the need for targeted interventions to reduce syncope recurrence and improve QoL. Objective This study aims to evaluate the efficiency of a structured educational programme in enhancing QoL among patients with recurrent RS. By focusing on patient education and reinforcement of syncope prevention strategies, this programme seeks to provide evidence supporting its integration into clinical practise. Methods We conducted a prospective study involving patients referred to head-up tilt testing (HUT) at our department between January 2023 and October 2024. Participants completed the Impact of Syncope on Quality of Life (ISQL) questionnaire at baseline. Post-HUT, patients engaged in a comprehensive educational and training programme aimed at mitigating syncope recurrence. Follow-up assessments, including ISQL re-evaluation and reinforcement of preventive measures, were conducted via teleconsultation at 3, 6, and 12 months. Results The study enrolled 163 patients (63.8% female; mean age 56.3 years), with 62% completing the programme. Syncope recurrence was observed in 21% (n=34) of participants, with a recurrence rate of 1.5 episodes per year; only 7% (n=11) required emergency department visits. Younger patients (≤40 years) with a hypotensive phenotype demonstrated the highest adherence to preventive measures. The mean ISQL score improved significantly from 44.9±12.1 at baseline to 54.9±6.4 at the final follow-up (p0.05), largely due to effective avoidance of specific triggers, such as "being in warm or hot environment" (severity at admission 6.35 vs. discharge 15.87) and "standing for long periods (5 min)" (severity at admission 6.35 vs. discharge 26.98), underscoring the value of targeted education. Conclusions Our findings demonstrate that a structured educational programme can significantly improve QoL in patients with recurrent RS by reducing syncope recurrence and fostering adherence to preventive strategies. This evidence supports the integration of patient-centred educational interventions into standard care protocols, highlighting the substantial benefit of structured education in managing RF effectively.