Jurnal Internasional Afrika vol.9 issue 3 2019
African Journal of Emergency Medicine A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt
Dublin Core
Title
Jurnal Internasional Afrika vol.9 issue 3 2019
African Journal of Emergency Medicine A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt
African Journal of Emergency Medicine A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt
Subject
ST-elevation myocardial infarction
South Africa
Telemedicine
Randomised controlled trials
Research methods
South Africa
Telemedicine
Randomised controlled trials
Research methods
Description
The incidence of cardiovascular disease and STEMI is on the rise in sub-Saharan Africa. Timely treatment is
essential to reduce mortality. Internationally, prehospital 12 lead ECG telemetry has been proposed to reduce
time to reperfusion. Its value in South Africa has not been established. The aim of this study was to determine the
effect of prehospital 12 lead ECG telemetry on the PCI-times of STEMI patients in South Africa. A multicentre
randomised controlled trial was attempted among adult patients with prehospital 12 lead ECG evidence of
STEMI. Due to poor enrolment and small sample sizes, meaningful analyses could not be made. The challenges
and lessons learnt from this attempt at Africa's first prehospital RCT are discussed. Challenges associated with
conducting this RCT related to the healthcare landscape, resources, training of paramedics, rollout and rando-
misation, technology, consent and research culture. High quality evidence to guide prehospital emergency care
practice is lacking both in Africa and the rest of the world. This is likely due to the difficulties with performing
prehospital clinical trials. Every trial will be unique to the test intervention and setting of each study, but by
considering some of the challenges and lessons learnt in the attempt at this trial, future studies might experience
less difficulty. This may lead to a stronger evidence-base for prehospital emergency care.
essential to reduce mortality. Internationally, prehospital 12 lead ECG telemetry has been proposed to reduce
time to reperfusion. Its value in South Africa has not been established. The aim of this study was to determine the
effect of prehospital 12 lead ECG telemetry on the PCI-times of STEMI patients in South Africa. A multicentre
randomised controlled trial was attempted among adult patients with prehospital 12 lead ECG evidence of
STEMI. Due to poor enrolment and small sample sizes, meaningful analyses could not be made. The challenges
and lessons learnt from this attempt at Africa's first prehospital RCT are discussed. Challenges associated with
conducting this RCT related to the healthcare landscape, resources, training of paramedics, rollout and rando-
misation, technology, consent and research culture. High quality evidence to guide prehospital emergency care
practice is lacking both in Africa and the rest of the world. This is likely due to the difficulties with performing
prehospital clinical trials. Every trial will be unique to the test intervention and setting of each study, but by
considering some of the challenges and lessons learnt in the attempt at this trial, future studies might experience
less difficulty. This may lead to a stronger evidence-base for prehospital emergency care.
Creator
Willem Stassen, Lee Wallis, Maaret Castren, Craig Vincent-Lambert, Lisa Kurland
Source
https://doi.org/10.1016/j.afjem.2019.02.002
Date
3 February 2019
Contributor
peri irawan
Format
pdf
Language
ENGLISH
Type
text
Files
Citation
Willem Stassen, Lee Wallis, Maaret Castren, Craig Vincent-Lambert, Lisa Kurland, “Jurnal Internasional Afrika vol.9 issue 3 2019
African Journal of Emergency Medicine A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/1770.
African Journal of Emergency Medicine A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/1770.