A Randomised Clinical Trial to Reduce Patient Prehospital Delay in Treatment in Acute Coronary Syndrome.

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dc.contributor.author Dracup, K en
dc.contributor.author McKinley, S en
dc.contributor.author Riegel, B en
dc.contributor.author Moser, D en
dc.contributor.author Meischke, H en
dc.contributor.author Doering, L en
dc.contributor.author Davidson, P en
dc.contributor.author Paul, S en
dc.contributor.author Baker, Heather en
dc.contributor.author Pelter, M en
dc.date.accessioned 2012-02-27T00:35:21Z en
dc.date.issued 2009 en
dc.identifier.citation Circulation: Cardiovascular Quality and Outcomes 2:524-532 2009 en
dc.identifier.issn 1941-7705 en
dc.identifier.uri http://hdl.handle.net/2292/12067 en
dc.description.abstract 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 randomized 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 randomized 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 counseling 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. en
dc.publisher American Heart Association en
dc.relation.ispartofseries Circulation: Cardiovascular Quality and Outcomes en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/1941-7713/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title A Randomised Clinical Trial to Reduce Patient Prehospital Delay in Treatment in Acute Coronary Syndrome. en
dc.type Journal Article en
dc.identifier.doi 10.1161/CIRCOUTCOMES.109.852608 en
pubs.begin-page 524 en
pubs.volume 2 en
dc.rights.holder Copyright: American Heart Association and Lippincott, Williams & Wilkins en
pubs.end-page 532 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 101032 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Nursing en
pubs.record-created-at-source-date 2010-09-01 en

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