The effects of public education through Short Message Service on the time from symptom onset to hospital arrival in patients with myocardial infarction: A field trial

BACKGROUND Patients' early hospital arrival is among the most important factors in minimizing the complications of myocardial infarction (MI). One of the measures which can reduce prehospital delay in these patients is public education. The aim of the present study was to investigate the effects of public education through Short Message Service (SMS) on the time from symptom onset to hospital arrival (or onset-to-door time) in patients with MI in Kashan, Iran. METHODS This field trial was done on 131 patients with definite diagnosis of myocardial infarction. Intervention included sending an educational short message about the symptoms of MI and the necessity of referring to hospital immediately. Logistic regression analysis was performed to evaluate the predictors of the onset-to-door time. RESULTS The results showed no significant difference in demographic characteristics, clinical variables and past medical history between the participants in the two groups. The onset-to-door time was significantly shorter in the intervention group than the control group (240.53 ± 156.60 vs. 291.70 ± 251.23, P= 0.003). Moreover, the onset-to-call time was significantly shorter in the intervention group than the control group (127.06 ± 202.62 vs. 44.32 ± 81.26, P = 0.002). The odds of arrival at hospital in the first 120 minutes after the onset of MI manifestations was 5.8 (2.04-16.8) times higher in the group that received the educational SMS. CONCLUSION As both the onset-to-door and onset-to-call times were shorter in the intervention group, it is suggested to use this method to raise the public awareness of MI symptoms and the need for early referral.