An Intervention to Reduce Prehospital Delay to Treatment in Acute Coronary Syndrome

Reducing Prehospital Delay in Acute Myocardial Infarction

This study was conducted to test whether a focused education and counseling intervention delivered by a nurse will decrease time of delay in seeking treatment for the signs and symptoms of acute coronary syndrome (i.e., heart attack) in patients already identified as having ischemic heart disease.

Delay to treatment from the onset acute coronary syndrome (ACS)continues to be a significant cause of morbidity and mortality. This study was conducted to evaluate a tailored education and counseling program designed for individuals at high risk for a future event. Study Hypothesis: The central hypothesis of this study was that a focused education and counseling intervention delivered by a nurse will decrease time of delay in seeking treatment for the signs and symptoms of AMI in patients already identified as having ischemic heart disease. Patients were randomized to receive a nurse-administered education and counseling intervention designed to promote early presentation for medical treatment in the face of cardiac symptoms or to usual instructions by their healthcare provider. Primary & Secondary Endpoints: The primary endpoint of this trial was prehospital delay time, i.e., time from onset of symptoms to arrival at the hospital. The secondary endpoints were: use of the emergency medical system; use of aspirin; healthcare resource utilization; and knowledge, attitudes and beliefs about heart disease.

Inclusion Criteria:

• a diagnosis of ischemic heart disease, confirmed by their physician or medical record
• lived independently (i.e., not in an institutional setting).

Exclusion Criteria:

• complicating serious co-morbidity such as a psychiatric illness or untreated malignancy
• neurological disorder with impaired cognition
• inability to read or understand English.
• major uncorrected hearing loss