@misc{10481/94219,
year = {2024},
month = {8},
url = {https://hdl.handle.net/10481/94219},
abstract = {Background and objective: Reducing patient decision delay – the time elapsed between symptom onset and the moment the patient decides to seek medical attention –
can help improve acute coronary syndrome survival. Patient decision delay is typically investigated in retrospective studies of acute coronary syndrome survivors
that are prone to several biases. To offer an alternative approach, the goal of this research was to investigate anticipated patient decision delay in the general
population in response to different symptom clusters.
Methods: We developed scenarios representing four commonly experienced symptom clusters: classic (chest symptoms only), heavy (a large number of very intense
symptoms including chest pain), diffuse (mild symptoms including chest pain), and weary (mild symptoms without clear chest involvement). The scenarios were
administered in random order in a representative survey of 1002 adults ≥55 years old from the non-institutionalized general population in Spain. We measured helpseeking
intentions, anticipated patient decision delay (waiting >30 min to seek help), and symptom attribution.
Results: Patient decision delay was most common in the diffuse scenario (55%), followed by the weary (34%), classic (22%), and heavy (11%) scenarios. Attributing
the symptoms to a cardiovascular cause and intentions to call emergency services were least frequent in the weary and diffuse scenarios. Women were less likely to
intend to seek help than men in the classic (OR = 0.48, [0.27, 0.85], diffuse (OR = 0.67, [0.48, 0.92]), and weary (OR = 0.66, [0.44, 0.98]) scenarios, despite being
more likely to attribute symptoms to cardiovascular causes. Participants with traditional cardiovascular risk factors (e.g., diabetes, hypercholesterolemia, hypertension)
reported faster help-seeking, whereas participants with obesity and history of depression were more likely to delay.
Discussion: The diverse manifestations of acute coronary syndrome generate fundamentally different appraisals. Anticipated patient decision delay varies as a
function of socio-demographic characteristics and medical history, supporting findings from studies with patients who experienced ACS. Measuring anticipated
patient decision delay in the general population can help reveal potential barriers to help-seeking and capture effects of population interventions.},
organization = {The Spanish Cardiobarometer study was funded by project PSI2014- 51842-R (Spanish Ministry of Economy and Competitiveness). DP was supported by a Juan de la Cierva Fellowship Grant JC2019-039691-I funded by MICIU/AEI/10.13039/501100011033 and a Miguel Servet Fellowship (CP23/00024) from the Health Institute Carlos III.},
publisher = {Elsevier},
keywords = {Acute coronary syndrome},
keywords = {Prehospital delay},
keywords = {Help‐seeking},
keywords = {Symptom clusters},
keywords = {Chest pain},
keywords = {Symptom appraisal},
title = {Anticipated prehospital decision delay in response to different symptom clusters in acute coronary syndrome: Results from the Spanish Cardiobarometer study},
doi = {10.1016/j.socscimed.2024.117263},
author = {Petrova, Dafina and Garrido del Águila, Dunia and Catena Martínez, Andrés and Ramírez Hernández, José Antonio and Blakoe, Mitti and Fernández Martínez, Nicolás Francisco and Pérez-Gómez, Beatriz and Sánchez Pérez, María José and García Retamero Imedio, María Del Rocío},
}