A Randomised Clinical Trial to Reduce Patient Prehospital Delay to Treatment in Acute Coronary Syndrome
MetadataShow full item record
Background: Delay from onset of acute coronary syndrome (ACS) symptoms to hospital admission continues to be prolonged. To date, community education campaigns on the topic have had disappointing results. Therefore, we conducted a clinical randomised trial to test whether an intervention tailored specifically for patients with ACS and delivered one-on-one would reduce prehospital delay time. Methods and Results: Participants (n=3522) with documented coronary heart disease were randomised to experimental (n=1777) or control (n=1745) groups. Experimental patients received education and counseling about ACS symptoms and actions required. Patients had a mean age of 67 +/- 11 years, and 68% were male. over the 2 years of follow-up, 565 patients (16.0%) were admitted to an emergency department with ACS symptoms a total of 842 times. Neither median prehospital delay time (experimental, 2.20 versus control, 2.25 hours) nor emergency medical system use (experimental, 63.6% versus control, 66.9%) was different between groups, although experimental patients were more likely than control to call the emergency medical system if the symptoms occurred within the first 6 months following the intervention (P=0.036). Experimental patients were significantly more likely to take aspirin after symptom onset than control patients (experimental, 22.3% versus control, 10.1%, P=0.02). The intervention did not result in an increase in emergency department use (experimental, 14.6% versus control, 17.5%). Conclusions: The education and counselling intervention did not lead to reduced prehospital delay or increased ambulance use. Reducing the time from onset of ACS symptoms to arrival at the hospital continues to be a significant public health challenge. Clinical Trial Registration: clinicaltrials.gov. Identifier NCT00734760.(Circ Cardiovasc Qual Outcomes. 2009;2:525-532).
Showing items related by title, author, creator and subject.
The Effect of Presenting Symptoms and Patient Characteristics on Prehospital Delay in MI Patients Presenting to Emergency Department by Ambulance: A Cohort StudyCoventry, L.; Bremner, A.; Williams, Teresa; Celenza, A. (2014)Introduction: There is little recent information about prehospital delay time for Australian patients with myocardial infarction (MI). Objectives: This study: (1) describes prehospital delay time for patients with MI; (2) ...
Coventry, Linda; Bremner, A.; Williams, Teresa; Jacobs, Ian; Finn, Judith (2014)Introduction: To further reduce time to definitive therapy for acute myocardial infarction (MI) patients, the focus of research needs to be on better understanding prehospital delay in recognition and response to symptoms. ...
Turner, Sian Elizabeth (2009)Background and research questions. The characterization of chronic persistent asthma in an older adult population is not well defined. This is due to the difficulties in separating the diagnosis of asthma from that of ...