Acute Coronary Syndrome Clinical Trial
— ASCENDOfficial title:
Ethnic Differences in Acute Coronary Syndromes Care in Emergency Departments.
Verified date | March 2018 |
Source | University of British Columbia |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
When doctors and nurses use accepted guidelines for quickly treating patients who come to the emergency department (ED) with a possible heart attack, patients do better. Research shows that there are racial-identity- and ethnicity-based differences in the symptoms these patients have, when and why they seek care, the treatments they receive, and how well they fare afterwards. There is also Canadian evidence that there may be racial-identity-based disparities in the care some patients receive, and it has been suggested that health professionals may unconsciously treat patients of different racial identities differently. But it is not known if there is racial-identity variation in the care given to Canadian patients with heart attack symptoms in the critical first hours after coming to an ED, or in their experiences of this care. The investigators collected information from the health records of patients who come to EDs with symptoms of heart attack. The investigators recorded events and times such as what provisional diagnosis was assigned to the patient, how often they received pain medication, how long until certain tests were performed and what treatments were offered. The investigators also collected information about things that might affect delivery of care, e.g., the number of doctors and nurses who were on duty. Participants also completed a short questionnaire about their reasons for coming to the hospital, how long they waited before coming and why, and what their experience in the ED was like. The investigators reviewed this information to see if there are racial-identity-based differences in the care received by patients with heart attack symptoms. The findings could identify important disparities, which could in turn inform future projects to correct these disparities, for example, education of health professionals about ethnic differences in ideas of health and illness.
Status | Completed |
Enrollment | 448 |
Est. completion date | April 12, 2017 |
Est. primary completion date | January 11, 2017 |
Accepts healthy volunteers | |
Gender | All |
Age group | 20 Years and older |
Eligibility |
Inclusion Criteria: - 20 years of age or older - presented to the ED and are either referred for immediate cardiology consultation or managed according to a standardized protocol for continued observation and referral for follow-up (whether ultimately admitted or not); - hemodynamically stable and free of ischemic discomfort for at least one hour - spoke English, Mandarin, Cantonese, Punjabi - able to provide informed consent. Exclusion Criteria: • being cared for by any of the Emergency physicians (3) who were co-investigators |
Country | Name | City | State |
---|---|---|---|
Canada | Richmond Hospital | Richmond | British Columbia |
Canada | Surrey Memorial Hospital | Surrey | British Columbia |
Canada | St. Paul's Hospital | Vancouver | British Columbia |
Lead Sponsor | Collaborator |
---|---|
University of British Columbia | Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Canada, Michael Smith Foundation for Health Research |
Canada,
Iacoe E, Ratner PA, Wong ST, Mackay MH. A cross-sectional study of ethnicity-based differences in treatment seeking for symptoms of acute coronary syndrome. Eur J Cardiovasc Nurs. 2017 Nov 1:1474515117741893. doi: 10.1177/1474515117741893. [Epub ahead of — View Citation
Mackay, M.H., Ratner, P.A., Scheuermeyer, F.X., Veenstra, G., Ramanathan, K.R., O'Sullivan, M.E., Grubisic, M., Murray, C., Humphries, K.H. (2017). Is racism a factor in emergency department care of patients with suspected acute coronary syndrome? Canadia
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Door to ECG | time from Emergency triage to first ECG acquisition | from hour and minute of admission until the hour and minute of first documented ECG, up to 48 hours | |
Secondary | Number of assessments by health professionals | The number of assessments by physicians and nurses during the ED stay. | from hour and minute of admission until the hour and minute of transfer to inpatient unit or discharge from Emergency Department, whichever comes first, up to 48 hours | |
Secondary | Rate of being offered and consenting to coronary angiogram | Rate of being offered and consenting to coronary angiogram among those having a diagnosis of acute coronary syndrome or myocardial infarction. | from date of admission until the date of hospital discharge, up to 100 weeks | |
Secondary | Rate of being offered and consenting to any revascularization procedure | Rate of being offered and consenting to any revascularization procedure among those having coronary atherosclerotic lesions >/= 70% in any vessel | from date of admission until the date of hospital discharge, up to 24 weeks | |
Secondary | ethnic differences in treatment-seeking delay | the time between symptom onset and the decision to seek medical help | from hour and minute of first documented symptoms until the hour and minute of first documented help-seeking, up to 168 hours |
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