Reducing patient delay in Acute Coronary Syndrome (RAPiD): Research protocol for a web-based Randomised Controlled Trial examining the effect of a behaviour change intervention

Citation

Farquharson B, Johnston M, Smith K, Williams B, Treweek S, Dombrowski SU, Dougall N, Abhyankar P & Grindle M (2017) Reducing patient delay in Acute Coronary Syndrome (RAPiD): Research protocol for a web-based Randomised Controlled Trial examining the effect of a behaviour change intervention. Journal of Advanced Nursing, 73 (5), pp. 1220-1234. https://doi.org/10.1111/jan.13191

Abstract
Aims  To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text+visual and text-only) with usual care.  Background  Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for Acute Coronary Syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions.  Design  A 3-arm web-based, parallel randomised controlled trial of a theory-based intervention.  Methods  The intervention comprises 12 behaviour change techniques systematically identified following systematic review and a consensus exercise undertaken with behaviour change experts. We aim to recruit n=177 participants who have experienced Acute Coronary Syndrome in the previous 6 months from a National Health Service Hospital. Consenting participants will be randomly allocated in equal numbers to one of three study groups: i) usual care ii) usual care plus text-only behaviour change technique-based intervention or iii) usual care plus text+visual behaviour change technique-based intervention. The primary outcome will be the change in intention to phone an ambulance immediately with symptoms of Acute Coronary Syndrome ≥15 minutes duration, assessed using two randomised series of 8 scenarios representing varied symptoms before and after delivery of the interventions or control condition (usual care). Funding granted January 2014.  Discussion  Positive results changing intentions would lead to a randomised controlled trial of the behaviour change intervention in clinical practice, assessing patient delay in the event of actual symptoms. This article is protected by copyright. All rights reserved.

Keywords
Acute Coronary Syndrome; ACS; delay; patient delay; behaviour; behaviour change; BCT; cardiac; nursing; intervention

Journal
Journal of Advanced Nursing: Volume 73, Issue 5