Reducing prehospital delay in Acute Myocardial Infarction

INTERVENTION: 54oo patients with documented ischaemic heart disease were randomised to the experimental intervention or to a care‐as‐usual group at six participating sites. The intervention group received face‐to‐face counselling about the symptoms of AMI and the importance of seeking treatment early, as well as emergency medical system (EMS) and aspirin use. They also received telephonic reinforcement of the intervention at one month follow‐up. Data are collected at baseline, immediately following the intervention, 3, 12 and 24 months. Instruments to be used include teh Response Questionnnaire, Cardiac Control Index, Brief Symptom Inventory Anxiety Subscale and teh Resource Utilisation Interview. Pre‐hospital delay, EMS use, aspirin use and resource utilisation are evaluated by means of medical record review and patient interview CONDITION: Coronary heart disease PRIMARY OUTCOME: 1. To compare length of prehospital delay in seeking treatment for AMI signs and symptoms in patients at risk for AMI whom previously received a focused education and counselling intervention with that of a control group who did not receive the intervention. 1a. To determine whether selected demographic variables interact with the intervention to affect length of prehospital delay time. 1b. To determine whether different means of health care payment interact with the intervention to affect the length of prehospital delay time. SECONDARY OUTCOME: To compare emergency medical system use rate between patients experiencing signs and symptoms of AMI who previously received a focused education and counselling intervention and a control group of those who did not receive the intervention. To determine whether different means of health care payment interact with the intervention to affect EMS use rates. EMS use are collected at the same time as above. To determine whether selected demographic variables interact with the intervention to affect EMS use rates. INCLUSION CRITERIA: 1. Have a diagnosis of ischaemic heart disease and 2. live independently.