Program Aids Hospital Compliance With Stroke Guidelines
TUESDAY Dec. 16, 2008 -- U.S. hospitals enrolled in a voluntary program to improve stroke patient treatment increased their adherence to national recommendations, according to a five-year study that included 790 hospitals that provided data on 322,847 stroke patients admitted from 2003 to 2007.
The hospitals, which signed on to the American Heart Association/American Stroke Association's Get With The Guidelines (GWTG) -- Stroke program, were assessed on how often they followed seven treatment recommendations for eligible acute stroke patients. The recommendations include: use of intravenous clot-busting drugs within two hours of stroke onset; medication to prevent blood clots within 48 hours of admission and at discharge; anti-thrombotic treatment for irregular heartbeat and high cholesterol; and counseling to quit smoking.
The study found that the number of stroke treatment recommendations performed in eligible patients increased from 83.5 percent in year one to 93.7 percent in year five of the study. For every year of participation in GWTG -- Stroke, hospitals were 18 percent more likely to deliver guideline-based care. When they focused on specific measures, the researchers found:
- The percentage of ischemic stroke patients treated with clot-busting drugs within two hours of stroke onset increased from 42 percent to 72.8 percent;
- The percentage of patients who tried to stop smoking increased from 65.2 percent to 93.6 percent;
- The percentage of patients being started on cholesterol-lowering drugs increased from 73.3 percent to 88.3 percent.
All hospitals in the study showed improvement, regardless of size, location and teaching status. The study was published in the Dec. 15 online issue of Circulation.
GWTG -- Stroke provides an online interactive assessment and report tool, resources, quarterly workshops, training and feedback to staff. The program's goal is to improve use of evidence-based treatments proven to reduce post-stroke complications and the risk of subsequent stroke or heart attack.
"These results indicate there is a very powerful effect to participating in the program," study author Dr. Lee H. Schwamm, a member of the GWTG -- Stroke program steering committee, said in an American Heart Association news release.
However, the researchers said there's still room for improvement.
"When there are more than 700,000 strokes every year in this country, each percentage point represents a huge reduction in actual risk," Schwamm said. "We shouldn't rest until we're at 100 percent for all measures."
The U.S. Food and Drug Administration has more about stroke prevention and treatment.
Posted: December 2008
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