An evidence-based plan of care (eg, GDMT) that pro- motes medication adherence, timely follow-up with the healthcare team, appropriate dietary and physi- cal activities, and compliance with interventions for secondary prevention should be provided to patients with NSTE-ACS. (Level of Evidence: C) 3. In addition to detailed instructions for daily exer- cise, patients should be given specific instruction on activities (eg, lifting, climbing stairs, yard work, and household activities) that are permissible and those to avoid. Specific mention should be made of resump- tion of driving, return to work, and sexual activ- (Level of Evidence: B) 4. An annual influenza vaccination is recommended for patients with cardiovascular disease.27,488 (Level of Evidence: C) Education of patients with NSTEMI and their families is criti- cal and often challenging, especially during transitions of care. Failure to understand and comply with a plan of care may account for the high rate of AMI rehospitalization rates in the United States.489,490 An important intervention to promote Figure 4. Stepped-Care Approach to Pharmacological Therapy for Musculoskeletal Symptoms in Patients With Known Cardiovascular Disease or Risk Factors for Ischemic Heart Disease. ASA indicates aspirin; COX-2, cyclooxygenase; GI, gastrointestinal; NSAIDs, nonsteroidal anti-inflammatory drugs; and PPI, proton-pump inhibitor. Modified from Jneid et al.8 coordination is to provide patients and caregivers with a com- prehensive plan of care and educational materials during the hospital stay that support compliance with evidence-based thera- The posthospitalization plan of care for patients with NSTE-ACS (Table 10) should address in detail several complex issues, including medication adherence and titration, timely follow-up, dietary interventions, physical and sexual activities, cardiac rehabilitation, compliance with interventions for second- ary prevention, and reassessment of arrhythmic and HF risks. 