Is primary angioplasty an acceptable alternative to thrombolysis? Quantitative and qualitative study of patient and carer satisfaction

Health Expect. 2010 Dec;13(4):350-8. doi: 10.1111/j.1369-7625.2009.00589.x.

Abstract

Objective: The National Infarct Angioplasty Project assessed the feasibility of establishing a comprehensive primary angioplasty service. We aimed to compare satisfaction at intervention hospitals offering angioplasty-based care and control hospitals offering thrombolysis-based care.

Design: Mixed methods, with postal survey of patients and their carers, supported by semi-structured interviews.

Setting and participants: Survey of 682 patients and 486 carers, and interviews with 33 patients and carers, in eight English hospitals.

Interventions: Primary angioplasty or thrombolysis.

Main outcome measures: Satisfaction with treatment.

Results: Responses were received from 595/682 patients (87%) and 418/486 carers (86%). Satisfaction with overall care was high at both intervention and control sites (78% vs. 71% patients rated their care as 'excellent', P = 0.074). Patient satisfaction was higher at intervention sites for some aspects of care such as speed of treatment (80% vs. 67%'excellent', P = 0.001). Convenience of visiting was rated lower at intervention sites by carers (12% vs. 1%'poor', P = 0.001). During interviews, carers reported that they accepted the added inconvenience of visiting primary angioplasty sites in the context of this life-saving treatment. Patient satisfaction with discharge and aftercare was lower in both treatment groups than for other aspects of care.

Conclusions: Reorganization of care to offer a primary angioplasty service was acceptable to patients and their carers. Satisfaction levels were high regardless of the type of care received, with the exception of discharge and aftercare.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty*
  • Caregivers / psychology*
  • England
  • Health Care Surveys
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / surgery*
  • Patient Satisfaction*
  • Thrombolytic Therapy*
  • Young Adult