Effects of a Public Awareness Campaign on Time to and Way of Hospital Admission After Stroke

Abstract

Public education campaigns are recommended to increase awareness for stroke. The effect of a public advertising and education campaign in an urban region in Germany was assessed and compared with a control region. We hypothesized that such a campaign would increase the number of patients being admitted by emergency medical services (EMS). A multimedia campaign and targeted education of health care professionals and the public was employed in Berlin during six consecutive months to disseminate knowledge about stroke symptoms and appropriate actions to take. Data on time to hospital admission and details on transport were retrieved from registries for the episode before, during, and after the campaign. To test the effect of the campaign, it was compared with another urban region in Germany (Ruhr-Area), where no campaign had been conducted. Between January 2010 and February 2011, 9,166 patients with stroke or transient ischemic attack (TIA) were documented in Berlin and 9,994 in the Ruhr-Area. In both regions, following the campaign period, patients were more often admitted to hospital within the first 2 hr after onset (Berlin: odds ratio [OR] = 1.16, 95% confidence interval [CI] = [1.02, 1.32]; Ruhr-Area: OR = 1.18, 95% CI = [1.05, 1.34]). Patients were more likely being admitted via EMS after the campaign (Berlin: OR = 1.71, 95% CI = [1.50, 1.94]; Ruhr-Area: OR = 1.34, 95% CI = [1.17, 1.53]). The results suggest that an increased uptake of EMS triggered shorter time to hospital admission. A reduction in delay to hospitalization and an increased uptake of EMS were observed over the study period for both regions. No effect of the campaign was identified.

The impact of a Danish stroke campaign: A cross‐sectional study

“…A recent study by Heuschmann et al evaluated a German campaign that took place in an urban region and compared it to a similar region without any campaign. They found that the proportion of patients admitted via EMS and within 2 h from symptom onset improved equally in both regions and concluded that the campaign had no effect 42 . However, the size and the budget of the campaign was unclear and some of the initiatives in the urban region could have influenced the public in the control region as well.…”

“…They found that the proportion of patients admitted via EMS and within 2 h from symptom onset improved equally in both regions and concluded that the campaign had no effect. 42 However, the size and the budget of the campaign was unclear and some of the initiatives in the urban region could have influenced the public in the control region as well. Some studies have found significant reductions in the prehospital delay after a campaign, for example, Chen et al, who conducted a controlled before-and-after study in China.…”

Initial cognitive impairment predicts shorter survival of patients with glioblastoma

“…The SSS score ranges from 0 to 58; low score indicates severe stroke. In the analyses, we divided scores into minor (43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58), moderate (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) and severe (0-25) stroke. 26 We adjusted for covariates in the multivariable regression analyses, as they were considered potential confounders.…”