Effects of educational television commercial on pre-hospital delay in patients with ischemic stroke wore off after the end of the campaign

摘要

Dear Editor, In patients with ischemic stroke, the time until initiation of therapy is an important factor for good clinical outcome because thrombolysis by intravenous tissue plasminogen activator or endovascular thrombectomy is only an option for a limited time after the onset of stroke. A number of campaigns have been conducted to increase awareness of stroke symptoms and to urge those suffering symptoms to visit hospital promptly when stroke is suspected. However, sufficient evidence for their effects on behavior changes of the lay public is not available [1]. We have previously shown that public education using a television commercial (TV-CM) reduced pre-hospital delay time in patients with ischemic cerebrovascular disease in Aomori Prefecture in northeastern Japan [2]. However, it remains unknown whether the effect persists even after the TV-CM broadcasting has ended. The aim of the present study was to resolve this question. The Government of Aomori Prefecture ran the TV-CM educational campaign for 4 years, from March 2012 to February 2016. The animated, 15-second TV-CM was created by RAB Service Co., Ltd. (Aomori, Japan) to improve prefectural residents' knowledge of stroke symptoms and to encourage early hospital visitation immediately after awareness of facial palsy, arm palsy, or speech disturbance. The concept was based on the 'Act-FAST' campaign in the United Kingdom [3]. Aomori Prefectural Central Hospital is a major hospital in the middle of the prefecture, serving a population of approximately 330,000. A database was prospectively constructed for acute ischemic cerebrovascular disease patients admitted to the hospital. Patients were included if they were hospitalized in the neurology department no later than 4 days after the onset of ischemic stroke or a transient ischemic attack.