Systematic review of interventions to reduce delay in patients with suspected heart attack

Kainth, A., Hewitt, A., Pattenden, J., Sowden, A., Duffy, S., Watt, I., Thompson, D. and Lewin R. (2004) Systematic review of interventions to reduce delay in patients with suspected heart attack. Emergency Medical Journal, 21 4: 506-508. doi:10.1136/emj.2003.013276


Author Kainth, A.
Hewitt, A.
Pattenden, J.
Sowden, A.
Duffy, S.
Watt, I.
Thompson, D.
Lewin R.
Title Systematic review of interventions to reduce delay in patients with suspected heart attack
Journal name Emergency Medical Journal   Check publisher's open access policy
ISSN 1472-0205
1472-0213
Publication date 2004-07-01
Sub-type Article (original research)
DOI 10.1136/emj.2003.013276
Open Access Status DOI
Volume 21
Issue 4
Start page 506
End page 508
Total pages 3
Editor Geoff Hughes
Kevin Mackway-Jones
Place of publication England
Publisher British Association for Accident & Emergency Medicine
Language eng
Subject 1102 Cardiovascular Medicine and Haematology
Abstract Objectives: To evaluate the effectiveness of interventions aiming to reduce time from onset of signs and symptoms of an acute myocardial infarction (AMI) to seeking medical help/arrival at hospital. Methods: A systematic review was conducted. Fifteen electronic databases, the internet, and bibliographies of included studies were searched, and experts in the field of cardiac care were contacted. Randomised controlled trials (RCTs), controlled trials, and before and after studies conducted in any setting that assessed an intervention aimed at reducing time from onset of signs and symptoms of an AMI to seeking medical help and/or arrival in hospital were eligible for inclusion. Results: Eleven media/public education intervention studies met the inclusion criteria. Five (one controlled and four before and after studies) reported the intervention to have a statistically positive effect on delay time and six (two RCTs and four before and after studies) reported no statistically significant effect. Three (one RCT and two before and after studies) of five studies evaluating the effect of the intervention on emergency department visits reported an increase in this outcome as a result of the intervention, and both studies (one RCT and one before and after study) examining calls made to emergency switchboards reported an increase in this outcome after the intervention. Conclusions: There was little evidence that media/public education interventions reduced delay. There is some evidence that they may result in an increase in emergency switchboard calls and emergency department visits. Despite substantial expenditure of time and effort, methodological deficiencies of the studies mean that it is not possible to make definitive recommendations. Abbreviations: RCT, randomised controlled trial; AMI, acute myocardial infarction Keywords: acute myocardial infarction; media campaign; public media campaign; systematic review Acute myocardial infarction (AMI) is the major cause of premature mortality in the UK and other western countries.1,2 The importance of prompt administration of thrombolytic therapy has lead to public education programmes to reduce time between onset of symptoms and treatment. This period consists of patient delay, transport time, and hospital time from admission to treatment.3 Patient delay is defined as time from onset of signs and symptoms of an AMI to when medical assistance is sought.4 Patient delay combined with transport time is referred to as prehospital delay. The UK National Service Framework recommends public education programmes encouraging people to call an ambulance in the event of symptoms suggestive of myocardial infarction.1 We conducted a systematic review to investigate the effectiveness of interventions aiming to reduce patient and/or prehospital delay.
Keyword acute myocardial infarction
media campaign
public media campaign
systematic review
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Nursing, Midwifery and Social Work Publications
 
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Created: Tue, 24 Mar 2009, 23:26:08 EST by Joanne Mellor on behalf of School of Nursing, Midwifery and Social Work