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

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Reducing Prehospital Delay in Acute Myocardial Infarction

Conditions
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Acute Coronary Syndrome

Intervention / Treatment
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* Behavioral: education


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A<br>a tailored, face-to-face education and counseling intervention with a nurse lasting approximately 45 minutes, followed by a telephonic reinforcement in 30 days | Behavioral: education<br>* face-to-face education and counseling intervention<br>* Other names: none applicable;|
| No Intervention: B<br>care-as-usual with data collection at the same time points as the experimental group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| time from ACS symptom onset to admission to emergency department |  | two years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pre-hospital aspirin use |  | two years | 
| emergency medical system use |  | two years | 
| resource utilization |  | two years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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patient education, acute coronary syndrome, prehospital delay to treatment