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Barriers to Patients Seeking Emergency Care for Acute Coronary Heart Disease
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To the Editor: It should come as no surprise that the community educational intervention described by Dr Luepker and colleagues1 had no impact on the average time interval from onset of symptoms suggestive of myocardial infarction to arrival at the emergency department. There have been other studies with similar interventions and similar results.2-3 One set of studies, conducted in Sweden, did show a statistically significant improvement in delay time.4 This difference from the US experience may have been due to the difference in health care–related financial barriers between the United States and Sweden. Even the Swedish study, however, showed no improvement in mortality rates.
A fundamentally different approach must be taken to realize the benefits that rapid initiation of reperfusion therapy can offer to persons experiencing myocardial infarction or stroke. The educational message must be more intensive than mass media announcements and public service messages and must deal with the . . . [Full Text of this Article]
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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
Russell V. Luepker, James M. Raczynski, Stravoula Osganian, Robert J. Goldberg, John R. Finnegan, Jr, Jerris R. Hedges, David C. Goff, Jr, Mickey S. Eisenberg, Jane G. Zapka, Henry A. Feldman, Darwin R. Labarthe, Paul G. McGovern, Carol E. Cornell, Michael A. Proschan, Denise G. Simons-Morton, and for the REACT Study Group
JAMA. 2000;284(1):60-67.
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