Seeking Treatment After Onset of Myocardial Infarction Symptoms: Why do Patients Delay?

Abstract

Prompt medical attention has the potential to reduce mortality and morbidity related to myocardial infarction. However, many patients do not receive maximum benefit because of a delay in reaching hospital Emergency Departments and definitive treatment. This study uses quantitative and qualitative methods to interview and survey patients (N=50) about their prehospital experiences following the onset of acute symptoms. Results of this study show that a median decision time of 1.5 hours accounted for the largest component of delay time. The findings of this study indicate that patient delay is the result of the interaction of a variety of factors: lengthy evaluation of symptoms by the patient and lay others, extensive self-treatment, and engagement in non-therapeutic activities. The study concludes that community health strategies should aim to reduce patient decision time. Although the usual pathway to hospital care is via the patient's general practitioner, this resulted in an extended response time. Education programs should recommend a more direct pathway to medical assistance. As most patients were at home and had a family member present at the onset of symptoms, recommendations made to reduce patient delay should also target family members.