UCLA

BACKGROUND: Patient delay in seeking treatment for acute coronary syndrome symptoms remains a problem. Thus, it is vital to test interventions to improve this behavior, but at the same time it is essential that interventions not increase anxiety. PURPOSE: To determine the impact on anxiety and perceived control of an individual face-to-face education and counseling intervention designed to decrease patient delay in seeking treatment for acute coronary syndrome symptoms. METHODS: This was a multicenter randomized controlled trial of the intervention in which anxiety data were collected at baseline, 3-months and 12-months. A total of 3522 patients with confirmed coronary artery disease were enrolled; data from 2597 patients with anxiety data at all time points are included. The intervention was a 45 min education and counseling session, in which the social, cognitive and emotional responses to acute coronary syndrome symptoms were discussed as were barriers to early treatment seeking. Repeated measures analysis of covariance was used to compare anxiety and perceived control levels across time between the groups controlling for age, gender, ethnicity, education level, and comorbidities. RESULTS: There were significant differences in anxiety by group (p = 0.03). Anxiety level was stable in patients in the control group, but decreased across time in the intervention group. Perceived control increased across time in the intervention group and remained unchanged in the control group (p = 0.01). CONCLUSION: Interventions in which cardiac patients directly confront the possibility of an acute cardiac event do not cause anxiety if they provide patients with appropriate strategies for managing symptoms.