title: Effect of a mass media campaign on ambulance use for chest pain.
abstract: OBJECTIVE
  To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain.
  
  
  METHODS
  A retrospective analysis of 253428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 - December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use.
  
  
  METHODS
  Monthly ambulance attendances.
  
  
  RESULTS
  The median number of monthly ambulance attendances for chest pain was 3609 (IQR, 3011-3891), but was higher in campaign months than in non-campaign months (3880 v 3234, P<0.001). After adjustments, campaign activity was associated with a 10.7% increase (95% CI, 6.5-14.9%; P<0.001) in monthly ambulance use for chest pain, and a 15.4% increase (95% CI, 10.1-20.9%; P<0.001) when the two-month lag periods were included. Clinical presentations for suspected acute coronary syndromes, as determined by paramedics, increased by 11.3% (95% CI, 6.9-15.9%; P<0.001) during campaigns. Although the number of patients transported to hospital by ambulance increased by 10.0% (95% CI, 6.1-14.2%; P<0.001) during campaign months, the number of patients not transported to hospital also increased, by 13.9% (95% CI, 8.3-19.8%; P<0.001).
  
  
  CONCLUSIONS
  A public awareness campaign about responding to prodromal acute myocardial infarction symptoms was associated with an increase in EMS use by people with chest pain and suspected acute coronary syndromes. Campaign activity may also lead to increased EMS use in low risk populations.
authors.affiliation: Ambulance Service of Victoria, Melbourne, VIC ziad.nehme@ambulance.vic.gov.au.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Nehme
authors.affiliation: Monash University, Melbourne, VIC.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
authors.affiliation: Monash University, Melbourne, VIC.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Akram
authors.affiliation: National Heart Foundation of Australia, Melbourne, VIC.
authors.forename: Harry
authors.initials: H
authors.lastname: Patsamanis
authors.affiliation: Monash University, Melbourne, VIC.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Bray
authors.affiliation: Monash Medical Centre, Melbourne, VIC.
authors.forename: Ian T
authors.initials: IT
authors.lastname: Meredith
authors.affiliation: Ambulance Service of Victoria, Melbourne, VIC.
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology; D000368:Aged; D000552:Ambulances / Q000706:statistics & numerical data*; D001315:Australia / Q000453:epidemiology; D002637:Chest Pain / Q000209:etiology*; D004632:Emergency Medical Services; D005260:Female; D006293:Health Promotion; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008402:Mass Media; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis*; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000706:statistics & numerical data / Q000639:trends