Effects of educational television commercial on pre-hospital delay in patients with ischemic stroke wore off after the end of the campaign

Nishijima, Haruo; Ueno, Takayoshi; Kon, Tomoya; Haga, Rie; Funamizu, Yukihisa; Arai, Akira; Suzuki, Chieko; Nunomura, Jin‐ichi; Baba, Masayuki; Tomiyama, Masahiko

doi:10.1016/j.jns.2017.08.3236

Cited by 9 publications

(14 citation statements)

References 6 publications

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“…At the same time, many studied patients or their relatives were not aware about the extent of the therapeutic window despite their recognition of early stroke symptoms. These results are in accordance with that of Dombrowski and colleagues [12] as well as Nishijima and colleagues [13] who identified that stroke symptoms recognition, previous experience of dealing with stroke patients and follow-up public as well as TV educational programs are associated with pre-hospital time reduction.…”

Section: Discussionsupporting

confidence: 92%

Stroke onset to needle delay: Where these golden hours are lost? An Egyptian center experience

Bahnasy

Elhassanien

2019

eNeurologicalSci

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BackgroundThe use of intravenous recombinant tissue plasminogen activator (IV r-tPA) in early acute ischemic stroke (AIS) management faces a lot of difficulties in developing countries due to lessened guideline development with consecutive pre- and intra-hospital delay.ObjectivesThe objective was to identify the barriers facing proper utilization of IV r-tPA for AIS in Tanta University Hospitals.MethodsThe study was conducted on 4124 AIS patients eligible to use IV r-tPA divided to group-I consisting of 442 patients who arrived the hospital within <3.5 h from the stroke onset and group-II consisting of 3682 patients who arrived >3.5 h from the stroke onset. The former group was further subdivided to 238 patients who received IV r-tPA (group-Ia) and 204 patients who did not receive IV r-tPA (group-Ib) due to different obstacles.ResultsThe main causes of pre-hospital onset to arrival delay were stroke unawareness, long travel time, incorrect beliefs, non-available neurologists, stroke onset during sleep and multiple causes (18.2%, 20.5%, 12.7%, 9.1%, 16% and 23.5% of cases, respectively). Causes of non-administration of IV r-tPA in eligible patients includes prolonged door-to-needle time, financial restraints, minor strokes, unavailable beds and fear of complications (41.2%, 26%, 12.7%, 11.3% and 8.8%, respectively).ConclusionIncreasing the chance of utilizing IV r-tPA for AIS patients' needs regular updating of the stroke chain of survival system to get the highest benefits from the available resources.

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Section: Discussionsupporting

confidence: 92%

Stroke onset to needle delay: Where these golden hours are lost? An Egyptian center experience

Bahnasy

Elhassanien

2019

eNeurologicalSci

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“…17 One explanation for the different effect in men and women could be the greater room International Journal of Stroke, 14 (9) for improvement in those with a poorer starting point, and the fact that women seem more receptive to health information. 10,18 Previous studies examining emergency department presentations for stroke symptoms, pre-hospital delay, and/or recanalization rates in patients with stroke report a decline after the end of campaigning, 8,9 suggesting that maintaining a sustained effect require campaigns to be run regularly. In the present study, we did not observe such post campaign decline, possibly explained by the long campaign period (27 months) and the small additional follow-up campaign.…”

Section: Subgroup or (95% Cl) Panal Amentioning

confidence: 99%

“…7 However, these effects seem to decline after campaign closure, suggesting that campaigns must be repeated regularly. 8,9 The Swedish Association of Local Authorities and Regions (SALAR; an organization representing all of Sweden's municipalities, county councils, and regions) developed and conducted a national stroke campaign that was carried out during 27 months from 2011 to 2013. In 2013, the World Stroke Organization awarded the campaign its prestigious top prize at the World Stroke Day Awards.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Swedish National Stroke Campaign: A population-based time-series study

Nordanstig

Palaszewski

Asplund

et al. 2019

International Journal of Stroke

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Background Time delay from stroke onset to hospital arrival is an important obstacle to recanalization therapy. To increase knowledge about stroke symptoms and potentially reduce delayed hospital arrival, a 27-month national public information campaign was conducted in Sweden. Aim To assess the effects of a national stroke campaign in Sweden. Methods This nationwide study included 97,840 patients with acute stroke, admitted to hospital and registered in the Swedish Stroke Register from 1 October 2010 to 31 December 2014 (one year before the campaign started to one year after the campaign ended). End points were (1) proportion of patients arriving at hospital within 3 h of stroke onset and (2) the proportion < 80 years of age receiving recanalization therapy. Results During the campaign, both the proportion of patients arriving at hospital within 3 h (p < 0.05) and the proportion receiving recanalization therapy (p < 0.001) increased. These proportions remained stable the year after the campaign, and no significant improvements with respect to the two end points were observed during the year preceding the campaign. In a multivariable logistic regression model comparing the last year of the campaign with the year preceding the campaign, the odds ratio of arriving at hospital within 3 h was 1.05 (95% confidence interval (CI): 1.00–1.09) and that of receiving recanalization was 1.34 (95% CI: 1.24–1.46). Conclusion The Swedish National Stroke Campaign was associated with a sustained increase in the proportion of patients receiving recanalization therapy and a small but significant improvement in the proportion arriving at hospital within 3 h.

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“…However, only a few studies showing a moderate effect on increasing the rate of IVT implemented detailed interventions to reduce time delays in the prehospital period, and the interventions included, for example, mass media and public awareness campaigns, professional education programs, and streamlined ambulance protocols. [ 16 , 20 , 92 – 94 ] Noted that the effect of comprehensive improving prehospital stroke code (OR, 1.83) was better than new transportation method (OR, 1.45) or educational program (OR, 1.38) alone (Fig. 7 ), which implied that the efforts made in this area called for multifaceted departments other than the hospital side alone and the role of EMS in stroke symptom recognition, patient transportation, and communication with hospital staff deserved the most attention for reducing prehospital delay.…”

Section: Discussionmentioning

confidence: 99%

Generalization of the right acute stroke promotive strategies in reducing delays of intravenous thrombolysis for acute ischemic stroke

Huang

Zhang

et al. 2018

Medicine

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Effects of educational television commercial on pre-hospital delay in patients with ischemic stroke wore off after the end of the campaign

Cited by 9 publications

References 6 publications

Stroke onset to needle delay: Where these golden hours are lost? An Egyptian center experience

Stroke onset to needle delay: Where these golden hours are lost? An Egyptian center experience

Evaluation of the Swedish National Stroke Campaign: A population-based time-series study

Generalization of the right acute stroke promotive strategies in reducing delays of intravenous thrombolysis for acute ischemic stroke

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