title: Effect of educational television commercial on pre-hospital delay in patients with ischemic stroke.
abstract: Administering intravenous recombinant tissue plasminogen activator (r-tPA) within 4.5 h or endovascular procedures within 8 h of ischemic stroke onset may reduce the risk of disability. The effectiveness of media campaigns to raise stroke awareness and shorten pre-hospital delay is unclear. We studied 1144 consecutive ischemic stroke patients at Aomori Prefectural Central Hospital, Japan, between March 2010 and February 2014. From March 2012, the government sponsored an educational campaign based on a television commercial to improve knowledge of stroke symptoms and encourage ambulance calls for facial palsy, arm palsy, or speech disturbance. For the 544 and 600 patients admitted before and during the intervention, respectively, we recorded the National Institutes of Health Stroke Scale score, stroke type, the time when patients or bystanders recognized stroke symptoms, and hospital arrival time. Pre-hospital delay, as the time interval from awareness of stroke to hospital arrival, was categorized as 0-3, 3-6, and 6+ h. The mean pre-hospital delay was shorter (12.0 vs 13.5 h; P = 0.0067), the proportion of patients arriving within 3 h was larger (55.7 vs 46.5 %; P = 0.0021), and the proportion arriving after 6 h was smaller (32.7 vs 39.5 %; P = 0.0162) in the intervention group than in the pre-intervention group. There was no significant difference in the proportion of patients treated with r-tPA (6 and 7.5 % of the intervention and pre-intervention groups, respectively). A television-based public education campaign potentially reduced pre-hospital delay for ischemic stroke patients, but the r-tPA treatment rate was unchanged.
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan. hnishijima-tky@umin.ac.jp.
authors: Haruo
authors: H
authors: Nishijima
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Tomoya
authors: T
authors: Kon
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Tatsuya
authors: T
authors: Ueno
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Rie
authors: R
authors: Haga
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Keishi
authors: K
authors: Yamazaki
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Kei
authors: K
authors: Yagihashi
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Yukihisa
authors: Y
authors: Funamizu
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Akira
authors: A
authors: Arai
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Chieko
authors: C
authors: Suzuki
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Jin-Ichi
authors: JI
authors: Nunomura
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Masayuki
authors: M
authors: Baba
authors: Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, 030-8553, Japan.
authors: Masahiko
authors: M
authors: Tomiyama
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology / Q000628:therapy*; D013690:Television; D013997:Time Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Ischemic stroke; Pre-hospital delay; Public education; Television commercial; Thrombolysis; Tissue plasminogen activator