17 Reducing patient delay in acute coronary syndrome: exploring the impact of an innovative digital intervention on real-world patient behaviour and creating a version for friends & family

<h3>Background</h3> Rapid access to treatment is critical in acute coronary syndrome (ACS). The ‘RAPiD’ digital behaviour change intervention is designed to reduce patient delay in people with a history of ACS. <h3>Aim</h3> To explore long-term (&gt;6 years) impact of the RAPiD intervention on patients‘ real-world responses to cardiac symptoms; to obtain qualitative feedback from patients and their significant others in order to enhance the intervention and adapt it for friends &amp; family. <h3>Methods</h3> Longitudinal follow-up of RAPiD trial participants conducted via retrospective cohort study and qualitative interviews thematically analysed using the Framework method. <h3>Results</h3> Of 101 original trial participants invited to this follow up study, 28 (27.7%) consented and completed a telephone survey of self-reported heart symptom episodes. Data on symptom episodes and delay times were extracted from medical records. Nearly 40% (11/28) reported no heart symptom episodes in the intervening &gt;6-year period. Of those who experienced ≥ 1 episodes, delay times ranged from &lt;15 minutes to several days. Twenty participated completed interviews, plus 12 significant others. Feedback on the intervention content highlighted the perceived importance of: (1.1) an unambiguous central message, (1.2) detailed and realistic condition-specific information, (1.3) diverse illustrative examples, (1.4) clear personal applicability. Format preferences to enhance engagement and impact were: (2.1) to present choice via variety of audio-visual, written and interactive elements, (2.2) to adopt a broadly accessible but not ‘patronising’ communication style. <h3>Conclusion</h3> Preliminary findings support some lasting impact of the RAPiD intervention in reducing patient-related delay with potential cardiac symptoms and facilitating contact with emergency services. Qualitative analysis evidences RAPiD’s overall acceptability and relevance for people with ACS and their significant others, plus insight into potential barriers and relevant modifications. Implications are discussed for person-based approaches to digital health behaviour change intervention development.