Follow-up of a 1-year media campaign on delay times and ambulance use in suspected acute myocardial infarction

Abstract

In order to reduce the delay times from onset of symptoms to arrival in hospital, and increase the use of ambulance in patients with suspected acute myocardial infarction (AMI), a media campaign was initiated in an urban area. An initial 3-week intense campaign was followed by a maintenance phase of 1 year. Delay times and ambulance use during the campaign were compared with the previous 21 months. Among patients admitted to a coronary care unit (CCU) due to suspected AMI, the median delay time was reduced from 3 h to 2 h 40 min and the mean delay time was reduced from 11 h 33 min to 7 h 42 min (P less than 0.001). Among patients with confirmed AMI the median delay time was reduced from 3 h to 2 h 20 min and the mean delay time from 10 h to 6 h 27 min (P less than 0.001). We conclude that a 1-year media campaign can reduce delay times in suspected AMI, and that this effect appears to continue at 1 year, but ambulance use seems to be more difficult to influence.

2012 ACCF/AHA Focused Update Incorporated Into the ACCF/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

“…115 In the National Registry of Myocardial Infarction 2, just over half (53%) of all patients with MI were transported to the hospital by ambulance. 111 Even in areas of the country that have undertaken substantial public education campaigns about the warning signs of ACS and the need to activate the EMS system rapidly, either there were no increases in EMS use 65,[116][117][118][119] or EMS use increased (as a secondary outcome measure) but was still suboptimal, with a 20% increase from a baseline of 33% in all 20 communities in the REACT study 70 and an increase from 27% to 41% in southern Minnesota after a community campaign. 120 Given the importance of patients using EMS for possible acute cardiac symptoms, communities, including medical providers, EMS systems, health care insurers, hospitals, and policy makers at the state and local level, need to have agreed-upon emergency protocols to ensure patients with possible heart attack symptoms will be able to access 9-1-1 without barriers, to secure their timely evaluation and treatment.…”

Rate of Admission and Long-Term Prognosis among Patients with Acute Chest Pain in the 1990s Compared with the 1980s

“…Fifteen years ago, an educational campaign was run in Göteborg with the aim of informing people about the possible risk of acute chest pain and the importance of immediate contact with health care professionals [7]. However, during that campaign, there was only a temporary increase in the number of patients admitted with chest pain [8].…”

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

“…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].…”

“…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].…”