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

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