Early reporting of myocardial infarction: impact of an experiment in patient education.

Abstract

Many deaths from myocardial infarction occur before medical help is sought. A campaign was mounted in Nottingham ("Nottingham Heartwatch") to encourage early reporting. A total of 13 828 men and women aged 40 and over registered with three general practices were asked to telephone a hospital-based number if they developed chest pain lasting for more than 10 minutes. Patients from study practices reported chest pain earlier after our invitation than they had before and also earlier than patients from control practices. While accepting the advice to call early some patients from the study practices ignored our special number and telephoned their general practitioner. The calls received on the Heartwatch line yielded a lower percentage of definite and probable infarcts than the calls received by the patients' own doctors.The way in which the characteristics of the study practices might have influenced this difference is discussed since it has considerable implications for largerscale attempts to bring patients with suspected myocardial infarction under medical care at the earliest opportunity.

Cognitive and Behavioral Aspects Affecting Early Referral of Acute Stroke Patients to Hospital

“…Previous research shows that education strategies can be effective. [23][24][25] Counselling strategies in other clinical scenarios have been shown to result in more timely health-seeking behavior. 15,26 However, a purely knowledge-based approach is unlikely to be sufficient, as reflected by the failure of some educational campaigns in relation to myocardial infarction.…”

Guidelines for the early management of patients with myocardial infarction

“…Mass public education campaigns might shorten this time. Such schemes, however, have been disappointing8 and do not seem to produce major long term benefits 9. On the other hand, up to 30% of patients presenting with a myocardial infarction are already known to have coronary heart disease, and such patients at high risk of coronary events, and their close relatives, would benefit from appropriate advice.…”

Duration of, and Temporal Trends (1994-1997) in, Prehospital Delay in Patients With Acute Myocardial Infarction

“…13 A limited number, albeit uncontrolled, of public education campaigns using a variety of educational ap- proaches have been performed in an attempt to reduce the extent of delay in seeking medical care in persons with symptoms of acute coronary disease. [14][15][16][17][18][19][20][21][22][23] Three of these studies have been conducted in the United States and 6 in other countries. Most of these studies measured changes in delay times from before the intervention to after its implementation and did not include a concurrent comparison group.…”