A study to explore the factors related to treatment seeking behaviour of patients with acute coronary syndrome in a tertiary care hospital at Chennai

Abstract

Objective: The aim of the study was to explore the factors related to treatment seeking behavior of patients with acute coronary syndrome (ACS) in a tertiary care hospital at Chennai, and to compare these factors between patients who sought treatment promptly and those who experienced delays. Method: A total of 250 patients diagnosed with ACS were included in this descriptive cross-sectional study. Participants were interviewed using standardized tools including the Acute Coronary Syndrome Response Index and the Modified Response to Symptoms Questionnaire. Data were collected on sociodemographic characteristics, clinical features, symptom recognition, attitudes, beliefs, and knowledge of ACS risk factors. Patients were categorized into timely treatment seekers (<2 hours) and delayers (2 hours or more). Results: Only 29.3% of patients sought timely treatment, while 50.6% experienced delays exceeding 8 hours. The mean knowledge score on ACS symptoms was higher among timely seekers (mean = 14.15) compared to delayers (mean = 13.27), though overall, 37.2% had inadequate knowledge. The most common interpretation of symptoms was indigestion (38.4%), and only 19.6% identified symptom onset as abrupt. A statistically significant correlation was found between knowledge of symptoms and risk factors (ρ = 0.000). Beliefs about ACS were also significantly associated with treatmentseeking delay (p = 0.043). Only 2% used ambulances, with 83.6% relying on family transport. Most symptoms began at home (67.1%), and while 70.4% told someone nearby, only 26.4% contacted emergency services. Pain was often described as discomfort (39.6%) and most commonly located in the chest (34%) and left shoulder (33.2%). Conclusion: The study concludes that limited knowledge of ACS symptoms and risk factors, misinterpretation of symptoms, low perceived seriousness, and inadequate use of emergency services are major contributors to treatment seeking delay. Strengthening community education and emergency response behaviours could reduce pre-hospital delay and improve ACS outcomes.