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August 6, 1994BMJOpen Access

Survey of general practitioners' prehospital management of suspected acute myocardial infarction

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Key result

In a survey of 180 general practitioners, 54% did not consider administering prehospital thrombolysis to be part of their job, and only 1% actually administered it in practice.

Population

180 general practitioners referring to Plymouth's coronary care unit, and 222 patients admitted with a final…

Design

Cross-sectional

Authors

ARA RoundUniversity of ExeterAMAndrew J. MarshallThe Royal Melbourne Hospital

Discussion

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Overview

GP reluctance to deliver prehospital thrombolysis may delay MI care; leaves open whether education or role redefinition improves uptake.

Study Design

Type

Cross-Sectional (n=180)

Multicenter

No

Structured PICO

P
Population
180 general practitioners in the Plymouth district surveyed on their attitudes and practices regarding prehospital management of suspected acute myocardial infarction.
E
Exposure
Survey of general practitioners regarding prehospital management (thrombolysis, aspirin, electrocardiography) of suspected acute myocardial infarction, alongside a retrospective review of hospital records.
O
Outcome
General practitioners' knowledge of and attitudes and behaviour towards patients with suspected acute myocardial infarction

Despite being well-informed, general practitioners were reluctant to administer prehospital thrombolysis or routine aspirin for suspected acute myocardial infarction, highlighting a barrier to reducing treatment delays.

Limitations

  • Geographically restricted to a single district
  • Relies partly on self-reported questionnaire data

Cite This Study

Round et al. (1994) conducted a cross-sectional in Suspected acute myocardial infarction (n=180). Prehospital management of suspected acute myocardial infarction was evaluated on Agreement that giving thrombolysis is part of a general practitioner's job (95% CI 15-26). In a survey of 180 general practitioners, 54% did not consider administering prehospital thrombolysis to be part of their job, and only 1% actually administered it in practice.

synapsesocial.com/papers/6a99e26d3984bcb448b4f2e6https://doi.org/10.1136/bmj.309.6951.375
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Attitudes of general practitioners to prehospital thrombolysis1994 · 21 citations
  2. 2Role of the general practitioner in managing patients with myocardial infarction: impact of thrombolytic treatment. Report of a British Heart Foundation Working Group.1989 · 22 citations
  3. 3Time delays in provision of thrombolytic treatment in six district hospitals. Joint Audit Committee of the British Cardiac Society and a Cardiology Committee of Royal College of Physicians of London.1992 · 125 citations
  4. 4Influences on general practitioners' use of pre-hospital thrombolysis: a qualitative study2004 · 3 citations
  5. 5Audit of prehospital thrombolysis by general practitioners in peripheral practices in Grampian1998 · 19 citations