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November 1, 2000

Barriers to Patients Seeking Emergency Care for Acute Coronary Heart Disease—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(17):2184. doi:10.1001/jama.284.17.2184

In Reply: In constructing the Rapid Early Action for Coronary Treatment (REACT) intervention, we did take into account most of the factors that Dr Nitzkin rightly lists as underlying patient delay.1 Indeed, our description of the REACT intervention included education of patients at high risk, health professional education, and community organization in addition to a media component. These intervention planning efforts have already been described in greater detail.25 In our formative data-gathering efforts, we also asked respondents whether cost was a barrier to seeking care and found that it was not commonly mentioned as such, although it likely does play a role in preventing patients from seeking care.6

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