ROLE OF PATIENT EDUCATION ON IMPROVING DOOR-TO-BALLOON TIMES FOR PRIMARY PCI IN PAKISTANI EMERGENCY DEPARTMENT
Main Article Content
Keywords
STEMI, primary PCI, door-to-balloon time, patient education, emergency department, Pakistan, clinical outcomes
Abstract
Background
Objective This study aims to evaluate the impact of a structured patient education program on improving D2B times for primary PCI in a Pakistani emergency department.
Methods A quasi-experimental design was employed at Lady Reading Hospital Peshawar from January to June 2023. Participants included 200 patients diagnosed with acute STEMI, presenting within 12 hours of symptom onset, and requiring primary PCI. The intervention consisted of educational sessions conducted by trained healthcare professionals using visual aids and informational brochures. Data were collected on baseline characteristics, D2B times, patient compliance, and satisfaction. Statistical analysis was performed using SPSS version 25.0.
Results The mean D2B time decreased from 90 minutes (SD ± 15) to 60 minutes (SD ± 10) post-intervention, with a statistically significant reduction (p < 0.001). Patient compliance improved from 70% to 90%, and satisfaction scores increased from 3.5 (SD ± 1.0) to 4.5 (SD ± 0.5) on a 5-point scale.
Conclusion
Acute ST-elevation myocardial infarction (STEMI) is a life-threatening condition that requires immediate medical intervention to restore coronary blood flow and minimize myocardial damage. Primary percutaneous coronary intervention (PCI) is the preferred treatment for STEMI, significantly reducing morbidity and mortality. The door-to-balloon (D2B) time, defined as the interval from patient arrival at the emergency department to balloon inflation during PCI, is crucial for optimizing clinical outcomes. International guidelines recommend a D2B time of 90 minutes or less. However, delays in D2B times remain a significant challenge in Pakistan.
Objective This study aims to evaluate the impact of a structured patient education program on improving D2B times for primary PCI in a Pakistani emergency department.
Methods A quasi-experimental design was employed at Lady Reading Hospital Peshawar from January to June 2023. Participants included 200 patients diagnosed with acute STEMI, presenting within 12 hours of symptom onset, and requiring primary PCI. The intervention consisted of educational sessions conducted by trained healthcare professionals using visual aids and informational brochures. Data were collected on baseline characteristics, D2B times, patient compliance, and satisfaction. Statistical analysis was performed using SPSS version 25.0.
Results The mean D2B time decreased from 90 minutes (SD ± 15) to 60 minutes (SD ± 10) post-intervention, with a statistically significant reduction (p < 0.001). Patient compliance improved from 70% to 90%, and satisfaction scores increased from 3.5 (SD ± 1.0) to 4.5 (SD ± 0.5) on a 5-point scale.
Conclusion
Structured patient education significantly reduced D2B times and improved patient compliance and satisfaction. These findings highlight the importance of patient education in enhancing clinical outcomes for STEMI patients in Pakistan, suggesting that such programs should be integrated into standard care protocols.
References
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2. American Heart Association. Mission: Lifeline STEMI Referring/Receiving Center Certification Manual. 2020.
3. Malik MA, Khan AH, Aslam N, Qureshi AM. Cardiovascular disease prevalence and its correlation with risk factors in rural areas of Pakistan. J Pak Med Assoc. 2011;61(4):377-381.
4. Mehta RH, Bufalino VJ, Pan W, et al. Achieving rapid reperfusion with primary percutaneous coronary intervention remains a challenge: insights from American Heart Association's Get With The Guidelines program. Am Heart J. 2008;155(6):1059-1067.
5. Moser DK, Kimble LP, Alberts MJ, et al. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council. Circulation. 2006;114(2):168-182.
6. Zeb S, Mahmood T, Naeem A, et al. Factors causing delay in initiation of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Pak J Med Sci. 2020;36(3):404-409.
7. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2004;110(9):588-636.
8. Moser DK, Kimble LP, Alberts MJ, et al. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council. Circulation. 2006;114(2):168-182.
9. Pereira AG, Marques AS, Silva MR, et al. Impact of patient education on adherence to treatment and glycemic control in patients with diabetes mellitus: a randomized controlled trial. J Diabetes Res. 2019;2019:1345921.
10. Clark NM, Gong M, Kaciroti N. A model of self-regulation for control of chronic disease. Health Educ Behav. 2001;28(6):769-782.
11. Bradley EH, Herrin J, Wang Y, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. N Engl J Med. 2006;355(22):2368-2377.
12. Davis RE, Jacklin R, Sevdalis N, et al. Patient involvement in patient safety: what factors influence patient participation and engagement? Health Expect. 2007;10(3):259-267.
13. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med. 1998;15(7):539-553.
14. Gale EA, Gillespie KM. Diabetes and gender. Diabetologia. 2001;44(1):3-15.
15. Haffner SM, Lehto S, Ronnemaa T, et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339(4):229-234.
16. Yusuf S, Reddy S, Ounpuu S, et al. Global burden of cardiovascular diseases: Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746-2753
2. American Heart Association. Mission: Lifeline STEMI Referring/Receiving Center Certification Manual. 2020.
3. Malik MA, Khan AH, Aslam N, Qureshi AM. Cardiovascular disease prevalence and its correlation with risk factors in rural areas of Pakistan. J Pak Med Assoc. 2011;61(4):377-381.
4. Mehta RH, Bufalino VJ, Pan W, et al. Achieving rapid reperfusion with primary percutaneous coronary intervention remains a challenge: insights from American Heart Association's Get With The Guidelines program. Am Heart J. 2008;155(6):1059-1067.
5. Moser DK, Kimble LP, Alberts MJ, et al. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council. Circulation. 2006;114(2):168-182.
6. Zeb S, Mahmood T, Naeem A, et al. Factors causing delay in initiation of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Pak J Med Sci. 2020;36(3):404-409.
7. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2004;110(9):588-636.
8. Moser DK, Kimble LP, Alberts MJ, et al. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council. Circulation. 2006;114(2):168-182.
9. Pereira AG, Marques AS, Silva MR, et al. Impact of patient education on adherence to treatment and glycemic control in patients with diabetes mellitus: a randomized controlled trial. J Diabetes Res. 2019;2019:1345921.
10. Clark NM, Gong M, Kaciroti N. A model of self-regulation for control of chronic disease. Health Educ Behav. 2001;28(6):769-782.
11. Bradley EH, Herrin J, Wang Y, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. N Engl J Med. 2006;355(22):2368-2377.
12. Davis RE, Jacklin R, Sevdalis N, et al. Patient involvement in patient safety: what factors influence patient participation and engagement? Health Expect. 2007;10(3):259-267.
13. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med. 1998;15(7):539-553.
14. Gale EA, Gillespie KM. Diabetes and gender. Diabetologia. 2001;44(1):3-15.
15. Haffner SM, Lehto S, Ronnemaa T, et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339(4):229-234.
16. Yusuf S, Reddy S, Ounpuu S, et al. Global burden of cardiovascular diseases: Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746-2753
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Published
Jun 19, 2024
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How to Cite
Dr Rafi Ullah, Dr Honey Raj Vishno, Dr Syed Muzammil Shah, Dr Muhammad Abdur Rauf, Dr Fahad Raja Khan, & Dr Ejaz Ul Haq. (2024). ROLE OF PATIENT EDUCATION ON IMPROVING DOOR-TO-BALLOON TIMES FOR PRIMARY PCI IN PAKISTANI EMERGENCY DEPARTMENT. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 2812-2818. https://doi.org/10.53555/jptcp.v31i6.7103
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Author Biographies
Dr Rafi Ullah
Cardiologist, Kuwait Teaching Hospital Peshawar, PakistanDr Honey Raj Vishno
Cardiology Resident, NICVD, Karachi, PakistanDr Syed Muzammil Shah
Medical Officer, Kuwait Teaching Hospital, Pakistan
Dr Muhammad Abdur Rauf
Assistant Professor of Cardiology, Kuwait Teaching Hospital/Peshawar Medical College Peshawar, PakistanDr Fahad Raja Khan
Fellow Interventional Cardiology, Peshawar Institute of Cardiology, Pakistan
Dr Ejaz Ul Haq
Fellow Interventional Cardiology, NICVD Karachi, PakistanHow to Cite
Dr Rafi Ullah, Dr Honey Raj Vishno, Dr Syed Muzammil Shah, Dr Muhammad Abdur Rauf, Dr Fahad Raja Khan, & Dr Ejaz Ul Haq. (2024). ROLE OF PATIENT EDUCATION ON IMPROVING DOOR-TO-BALLOON TIMES FOR PRIMARY PCI IN PAKISTANI EMERGENCY DEPARTMENT. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 2812-2818. https://doi.org/10.53555/jptcp.v31i6.7103