School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK.
School of Health Sciences, University of Stirling, Stirling, UK.
Open Heart. 2019 Feb 27;6(1):e000975. doi: 10.1136/openhrt-2018-000975. eCollection 2019.
Time to treatment in many conditions, particularly acute coronary syndrome, is critical to reducing mortality. Delay between onset of symptoms and treatment remains a worldwide problem. Reducing patient delay has been particularly challenging. Embedding behaviour change techniques (BCTs) within interventions might lead to shorter delay.
To identify which BCTs are associated with reductions in patient delay among people with symptoms or conditions where time to treatment is critical.
The data sources were Cochrane Library, MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Study eligibility criteria include intervention evaluations (randomised controlled trials, controlled clinical trials and cohort studies) involving adults (aged >18 years) and including an outcome measure of patient delay up to August 2016. Study appraisal and synthesis methods include screening potential studies using a transparent, replicable process. Study characteristics, outcomes and BCTs were extracted from eligible studies.
From 39 studies (200 538 participants), just over half (n=20) reported a significant reduction in delay. 19 BCTs were identified, plus 5 additional techniques, with a mean of 2 (SD=2.3) BCTs and 2 (SD=0.7) per intervention. No clear pattern between BCTs and effectiveness was found. In studies examining patient delay specifically, three of four studies that included two or more BCTs, in addition to the two most commonly used additional techniques, reported a significant reduction in delay.
Around half of the interventions to reduce prehospital delay with time-critical symptoms report a significant reduction in delay time. It is not clear what differentiates effective from non-effective interventions, although in relation to patient delay particularly additional use of BCTs might be helpful.
CRD42014013106.
在许多情况下，包括急性冠状动脉综合征在内，从发病到治疗的时间对于降低死亡率至关重要。症状出现与治疗之间的延迟仍然是一个全球性的问题。减少患者的延迟尤其具有挑战性。在干预措施中嵌入行为改变技术（BCTs）可能会导致延迟时间缩短。
确定哪些 BCT 与时间关键型症状或疾病患者的延迟时间缩短有关。
数据来源包括 Cochrane Library、MEDLINE、EMBASE、Cumulative Index to Nursing and Allied Health Literature 和 PsycINFO。研究入选标准包括针对成年人（年龄>18 岁）的干预评估（随机对照试验、对照临床试验和队列研究），并包括截至 2016 年 8 月的患者延迟的结果测量。研究评估和综合方法包括使用透明、可复制的过程筛选潜在的研究。从合格研究中提取研究特征、结局和 BCT。
从 39 项研究（200538 名参与者）中，超过一半（n=20）报告了延迟的显著减少。确定了 19 种 BCT，外加 5 种额外技术，每种干预措施平均有 2（SD=2.3）种 BCT 和 2（SD=0.7）种额外技术。未发现 BCT 和效果之间存在明显的模式。在专门研究患者延迟的研究中，纳入了两种或更多 BCT 的四项研究中的三项，以及两种最常用的额外技术，报告了延迟时间的显著减少。
大约一半的针对时间关键症状的院前延迟减少干预措施报告了延迟时间的显著减少。目前尚不清楚哪些因素可以区分有效和无效的干预措施，尽管在患者延迟方面，额外使用 BCT 可能会有所帮助。
CRD42014013106。
