Abstract
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.
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Selected References
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- Ashton K. C. How men and women with heart disease seek care: the delay experience. Prog Cardiovasc Nurs. 1999 Spring;14(2):53-60, 74. [PubMed] [Google Scholar]
- Bett N., Aroney G., Thompson P. Impact of a national educational campaign to reduce patient delay in possible heart attack. Aust N Z J Med. 1993 Apr;23(2):157–161. doi: 10.1111/j.1445-5994.1993.tb01810.x. [DOI] [PubMed] [Google Scholar]
- Blohm M. B., Hartford M., Karlson B. W., Luepker R. V., Herlitz J. An evaluation of the results of media and educational campaigns designed to shorten the time taken by patients with acute myocardial infarction to decide to go to hospital. Heart. 1996 Nov;76(5):430–434. doi: 10.1136/hrt.76.5.430. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Blohm M., Hartford M., Karlson B. W., Karlsson T., Herlitz J. A media campaign aiming at reducing delay times and increasing the use of ambulance in AMI. Am J Emerg Med. 1994 May;12(3):315–318. doi: 10.1016/0735-6757(94)90147-3. [DOI] [PubMed] [Google Scholar]
- Gaspoz J. M., Unger P. F., Urban P., Chevrolet J. C., Rutishauser W., Lovis C., Goldman L., Héliot C., Séchaud L., Mischler S. Impact of a public campaign on pre-hospital delay in patients reporting chest pain. Heart. 1996 Aug;76(2):150–155. doi: 10.1136/hrt.76.2.150. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ho M. T., Eisenberg M. S., Litwin P. E., Schaeffer S. M., Damon S. K. Delay between onset of chest pain and seeking medical care: the effect of public education. Ann Emerg Med. 1989 Jul;18(7):727–731. doi: 10.1016/s0196-0644(89)80004-6. [DOI] [PubMed] [Google Scholar]
- Luepker R. V., Raczynski J. M., Osganian S., Goldberg R. J., Finnegan J. R., Jr, Hedges J. R., Goff D. C., Jr, Eisenberg M. S., Zapka J. G., Feldman H. A. Effect of a community intervention on patient delay and emergency medical service use in acute coronary heart disease: The Rapid Early Action for Coronary Treatment (REACT) Trial. JAMA. 2000 Jul 5;284(1):60–67. doi: 10.1001/jama.284.1.60. [DOI] [PubMed] [Google Scholar]
- Meischke H., Dulberg E. M., Schaeffer S. S., Henwood D. K., Larsen M. P., Eisenberg M. S. 'Call fast, Call 911': a direct mail campaign to reduce patient delay in acute myocardial infarction. Am J Public Health. 1997 Oct;87(10):1705–1709. doi: 10.2105/ajph.87.10.1705. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mitic W. R., Perkins J. The effect of a media campaign on heart attack delay and decision times. Can J Public Health. 1984 Nov-Dec;75(6):414–418. [PubMed] [Google Scholar]
- Moses H. W., Engelking N., Taylor G. J., Prabhakar C., Vallala M., Colliver J. A., Silberman H., Schneider J. A. Effect of a two-year public education campaign on reducing response time of patients with symptoms of acute myocardial infarction. Am J Cardiol. 1991 Jul 15;68(2):249–251. doi: 10.1016/0002-9149(91)90753-8. [DOI] [PubMed] [Google Scholar]
- Pattenden Jill, Watt Ian, Lewin Robert J. P., Stanford Neil. Decision making processes in people with symptoms of acute myocardial infarction: qualitative study. BMJ. 2002 Apr 27;324(7344):1006–1009. doi: 10.1136/bmj.324.7344.1006. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rowley J. M., Hill J. D., Hampton J. R., Mitchell J. R. Early reporting of myocardial infarction: impact of an experiment in patient education. Br Med J (Clin Res Ed) 1982 Jun 12;284(6331):1741–1746. doi: 10.1136/bmj.284.6331.1741. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rustige J., Schiele R., Schneider J., Senges J. Intravenöse Thrombolyse beim akuten Myokardinfarkt: Optimierung der Therapiestrategie durch Aufklärung von Patienten und Arzten. Anasthesiol Intensivmed Notfallmed Schmerzther. 1992 Jun;27(4):205–208. doi: 10.1055/s-2007-1000282. [DOI] [PubMed] [Google Scholar]
- Ruston A. Accessing emergency care at the time of a heart attack: why people do not dial 999 for an ambulance. J R Soc Promot Health. 2001 Dec;121(4):243–247. doi: 10.1177/146642400112100408. [DOI] [PubMed] [Google Scholar]
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