Consequences of a media campaign focusing on delay in acute myocardial infarction

Blohm, M; Herlitz, Johan; Hartford, Marianne; Karlson, Björn W.; Risenfors, Martin; Luepker, Russell V.; Sjölin, Margareta; Holmberg, Stig

doi:10.1016/0002-9149(92)90244-s

Cited by 51 publications

(24 citation statements)

References 5 publications

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“…24,25 For patients at risk for ACS (and for their families), primary care physicians and other healthcare providers should consider discussing the appropriate use of aspirin and activation of EMS system. Furthermore, an awareness of the location of the nearest hospital that offers 24-hour emergency cardiovascular care can also be included in this discussion.…”

Section: Prehospital Management Patient and Healthcare Provider Recogmentioning

confidence: 99%

Part 10: Acute Coronary Syndromes

O’Connor¹,

Brady²,

Brooks³

et al. 2010

Circulation

238

167

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Section: Prehospital Management Patient and Healthcare Provider Recogmentioning

confidence: 99%

Part 10: Acute Coronary Syndromes

O’Connor¹,

Brady²,

Brooks³

et al. 2010

Circulation

238

167

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“…About two thirds of patients with AMI ad mitted to the coronary care unit and a simi lar fraction of the general public interviewed by telephone were aware of the campaign. A more detailed description of this part of the campaign is given elsewhere [7,8].…”

Section: Resultsmentioning

confidence: 99%

“…the impact on the emergency department vol ume of chest pain patients during a pro longed follow-up. A detailed description of the impact on delay times and the public's awareness of the campaign is presented else where [7,8].…”

Section: Introductionmentioning

confidence: 99%

Effect of a Media Campaign to Reduce Delay Times for Acute Myocardial Infarction on the Burden of Chest Pain Patients in the Emergency Department

et al. 1991

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We evaluated the effect of a media campaign aimed at reducing delay times in suspected acute myocardial infarction (AMI) on the volume of chest pain patients seen in the emergency department. During the 1st week of the campaign, the mean number of chest pain patients increased from 10.5 per day prior to the start to 25.4. However, the number declined rapidly in subsequent months. The greatest increase was observed in patients with chest pain in whom AMI was not suspected on examination. During the campaign, 4,805 patients with chest pain appeared in the emergency department as compared with 4,407 patients during the same time period prior to its start, an increase of 9 %. The number of patients with confirmed AMI increased from 595 to 629 (6%).

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“…10 However, the baseline mean delay time for the REACT population was shorter than reported previously. 12,13 Perhaps in communities with relatively short delay times, the impact of a community educational intervention on time-dependent cardiac therapy will be limited. Interestingly, the odds for reperfusion therapy use consistently increased during the early months of the intervention.…”

Section: Discussionmentioning

confidence: 99%

Impact of Community Intervention to Reduce Patient Delay Time on Use of Reperfusion Therapy for Acute Myocardial Infarction Rapid Early Action for Coronary Treatment (REACT) Trial

Hedges

Feldman

Bittner

et al. 2000

Academic Emergency Medicine

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Abstract. Background: Reperfusion therapy for acute myocardial infarction (AMI) is a time-dependent intervention that can reduce infarct-related morbidity and mortality. Out-of-hospital patient delay from symptom onset until emergency department (ED) presentation may reduce the expected benefit of reperfusion therapy. Objective: To determine the impact of a community educational intervention to reduce patient delay time on the use of reperfusion therapy for AMI. Methods: This was a randomized, controlled community-based trial to enhance patient recognition of AMI symptoms and encourage early ED presentation with resultant increased reperfusion therapy rates for AMI. The study took place in 44 hospitals in 20 pair-matched communities in five U.S. geographic regions. Eligible study subjects were noninstitutionalized patients without chest injury (aged Ն30 years) who were admitted to participating hospitals and who received a hospital discharge diagnosis of AMI (ICD 410); n = 4,885. For outcome assessment, patients were excluded if they were without survival data (n = 402), enrolled in thrombolytic trials (n = 61), receiving reperfusion therapy >12 hours after ED arrival (n = 628), or missing symptom onset or reperfusion times (n = 781). The applied intervention was an educational program targeting community organizations and the general public, high-risk patients, and health professionals in target communities. The primary outcome was a change in the proportion of AMI patients receiving early reperfusion therapy (i.e., within one hour of ED arrival or within six hours of symptom onset). Trends in reperfusion therapy rates were determined after adjustment for patient demographics, presenting blood pressure, cardiac history, and insurance status. Four-month baseline was compared with the 18-month intervention period. Results: Of 3,013 selected AMI patients, 40% received reperfusion therapy. Eighteen percent received therapy within one hour of ED arrival (46% of treated patients), and 32% within six hours of symptom onset (80% of treated patients). No significant difference in the trends in reperfusion therapy rates was attributable to the intervention, although increases in early reperfusion therapy rates were noted during the first six months of the intervention. A significant association of early reperfusion therapy use with ambulance use was identified. Conclusions: Community-wide educational efforts to enhance patient response to AMI symptoms may not translate into sustained changes in reperfusion practices. However, an increased odds for early reperfusion therapy use during the initiation of the intervention and the association of early therapy with ambulance use suggest that reperfusion therapy rates can be enhanced.

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Consequences of a media campaign focusing on delay in acute myocardial infarction

Cited by 51 publications

References 5 publications

Part 10: Acute Coronary Syndromes

Part 10: Acute Coronary Syndromes

Effect of a Media Campaign to Reduce Delay Times for Acute Myocardial Infarction on the Burden of Chest Pain Patients in the Emergency Department

Impact of Community Intervention to Reduce Patient Delay Time on Use of Reperfusion Therapy for Acute Myocardial Infarction Rapid Early Action for Coronary Treatment (REACT) Trial

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