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

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dc.contributor.author Dracup, Kathleen en_US
dc.contributor.author Mckinley, Sharon en_US
dc.contributor.author Riegel, Barbara en_US
dc.contributor.author Moser, Debra en_US
dc.contributor.author Meischke, Hendrika en_US
dc.contributor.author Doering, Lynn en_US
dc.contributor.author Davidson, Patricia en_US
dc.contributor.author Paul, Stephen en_US
dc.contributor.author Baker, Heather en_US
dc.contributor.author Pelter, Michelle en_US
dc.contributor.editor en_US
dc.date.accessioned 2010-05-28T09:51:37Z
dc.date.available 2010-05-28T09:51:37Z
dc.date.issued 2009 en_US
dc.identifier 2009000697 en_US
dc.identifier.citation Dracup Kathleen et al. 2009, 'A randomized clinical trial to reduce patient prehospital delay to treatment in acute coronary syndrome', Lippincott Williams and Wilkins, vol. 2, no. 6, pp. 524-532. en_US
dc.identifier.issn 1941-7713 en_US
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%). Conclusionsi?? 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. en_US
dc.language en_US
dc.publisher Lippincott Williams and Wilkins en_US
dc.relation.isbasedon http://dx.doi.org/10.1161/CIRCOUTCOMES.109.852608 en_US
dc.title A randomized clinical trial to reduce patient prehospital delay to treatment in acute coronary syndrome en_US
dc.parent Circulation. Cardiovascular Quality and Outcomes en_US
dc.journal.volume 2 en_US
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 111003 en_US
dc.personcode 106354 en_US
dc.personcode 930003 en_US
dc.personcode 0000017426 en_US
dc.personcode 105630 en_US
dc.personcode 0000054604 en_US
dc.personcode 0000035328 en_US
dc.personcode 110950 en_US
dc.personcode 0000046645 en_US
dc.personcode 0000054679 en_US
dc.personcode 0000034424 en_US
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 myocardial infarction acute coronary syndrome en_US


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