Key result
A disparity-reduction intervention comprising specialized triage and patient navigation significantly reduced pain intensity and threat perception compared to routine care in vulnerable patients with acute coronary syndrome.
Why the study?
Marginalized patients with acute coronary syndrome often face inequitable care in emergency departments with negative consequences, but the impact of a disparity-reduction intervention on outcomes remained unproven.
Does a disparity-reduction intervention comprising improved triage and patient navigation improve pain management, illness perception, and care timelines in vulnerable patients with acute coronary syndrome?
RCT (n=264)
Double-blind
Stratified block randomization
No
Does a disparity-reduction intervention comprising improved triage and patient navigation improve pain management, illness perception, and care timelines in vulnerable patients with acute coronary syndrome?
Answers are grounded in this paper and cite their sources.
Implementing a specialized triage and patient navigation program in the emergency department significantly improves care timelines, pain management, and follow-up adherence for vulnerable patients with acute coronary syndrome.
BACKGROUND: Patients with acute coronary syndrome (ACS) who belong to marginalized groups often do not receive equitable treatment and care when they are referred to emergency departments (ED), and this can have negative consequences for these patients. Therefore, this study aimed to evaluate the impact of a disparity-reduction intervention on outcomes of patients with ACS in the ED. METHODS: This randomized clinical trial included 264 ACS patients, randomly allocated into intervention (n = 132) and control group (n = 132). The intervention involved improving the triage process by (1) welcoming nurses and (2) conducting specialized triage. Also, a patient navigation (PN) program was implemented, comprising (1) emergency care comprehensive management, (2) supportive education and counseling, and (3) clinical actions with follow-up care. In the control group, standard triage and routine care were provided. Outcomes assessed included pain intensity, patient opinion of pain management, illness perception, threat perception, and short and long-term outcomes. RESULTS: The results showed that after the intervention, pain intensity and threat perception decreased significantly in the intervention group compared to the control group (P < 0.001). Moreover, the opinion of pain management-assessed only post-intervention-was significantly more favorable in the intervention group than in the control group (P < 0.001). Illness perception scores also increased more prominently in the intervention group than in the control group (P < 0.001). Short-term outcomes showed improvement in the intervention group compared to the control group (P < 0.05). Long-term outcomes revealed that the intervention group experienced better results than the control group in specialist visits, exercise stress tests, echocardiography, and readmissions (P < 0.05). CONCLUSION: Interventions such as improving the triage process and the PN are important in reducing disparities and improving patient outcomes. These findings underscore the effectiveness of tailored strategies in promoting equitable care in ED.
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Yarahmadi et al. (2025) conducted an RCT in Acute Coronary Syndrome (ACS) (n=264). Disparity-reduction intervention (specialized triage and patient navigation program) vs. Standard triage and routine care was evaluated on Pain intensity (Numerical Rating Scale) (p=<0.001). A disparity-reduction intervention comprising specialized triage and patient navigation significantly reduced pain intensity and threat perception compared to routine care in vulnerable patients with acute coronary syndrome.
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