A randomized clinical trial to reduce patient prehospital delay to treatment in acute coronary syndrome.

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dc.contributor.author Dracup, K
dc.contributor.author McKinley, S
dc.contributor.author Riegel, B
dc.contributor.author Moser, DK
dc.contributor.author Meischke, H
dc.contributor.author Doering, LV
dc.contributor.author Davidson, P
dc.contributor.author Paul, SM
dc.contributor.author Baker, H
dc.contributor.author Pelter, M
dc.date.accessioned 2010-05-28T09:51:37Z
dc.date.issued 2009-11
dc.identifier.citation Circulation. Cardiovascular quality and outcomes, 2009, 2 (6), pp. 524 - 532
dc.identifier.issn 1941-7713
dc.identifier.other C1 en_US
dc.identifier.uri http://hdl.handle.net/10453/9750
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. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov. Identifier NCT00734760.
dc.format Print-Electronic
dc.language eng
dc.relation.isbasedon 10.1161/circoutcomes.109.852608
dc.title A randomized clinical trial to reduce patient prehospital delay to treatment in acute coronary syndrome.
dc.type Journal Article
dc.parent Circulation. Cardiovascular quality and outcomes
dc.journal.volume 6
dc.journal.volume 2
dc.journal.number 6 en_US
dc.publocation United States of America en_US
dc.identifier.startpage 524 en_US
dc.identifier.endpage 532 en_US
dc.cauo.name FOH.Faculty of Health en_US
dc.conference Verified OK en_US
dc.for 1117 Public Health and Health Services
dc.for 111003 Clinical Nursing: Secondary (Acute Care)
dc.personcode 930003
dc.personcode 106354
dc.personcode 110950
dc.personcode 105630
dc.percentage 67 en_US
dc.classification.name Clinical Nursing: Secondary (Acute Care) en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
dc.description.keywords Humans
dc.description.keywords Aspirin
dc.description.keywords Platelet Aggregation Inhibitors
dc.description.keywords Counseling
dc.description.keywords Health Knowledge, Attitudes, Practice
dc.description.keywords Emergency Medical Services
dc.description.keywords Emergency Service, Hospital
dc.description.keywords Aged
dc.description.keywords Aged, 80 and over
dc.description.keywords Patient Education as Topic
dc.description.keywords Logistic Models
dc.description.keywords Acute Coronary Syndrome
dc.description.keywords Patient Admission
dc.description.keywords Time Factors
dc.description.keywords United States
dc.description.keywords Australia
dc.description.keywords New Zealand
dc.description.keywords Female
dc.description.keywords Male
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Health
pubs.organisational-group /University of Technology Sydney/Strength - Health Services and Practice Research
utslib.copyright.status Closed Access
utslib.copyright.date 2015-04-15 12:17:09.805752+10
pubs.consider-herdc true
utslib.collection.history Closed (ID: 3)


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