Thrombolytic treatment for stroke in the Scandinavian countries.
OBJECTIVE
We wanted to describe the use of thrombolytic treatment for stroke in Scandinavia, to assess stroke doctors' opinions on this treatment, to identify barriers against treatment, and to suggest improvements to overcome these barriers.


METHODS
We sent questionnaires to 493 Scandinavian doctors, who were involved in acute stroke care.


RESULTS
We received 453 (92%) completed questionnaires. Overall, 1.9% (range per hospital 0-13.9%) of patients received thrombolytic treatment. A majority (94%) of the respondents was convinced of the beneficial effects of thrombolytic treatment and many (85%) felt that its risks were acceptable. Main barriers were: unawareness of stroke symptoms among patients (82%) and their failure to respond adequately (54%); ambulance services not triaging acute stroke as urgent (23%); and insufficient in-hospital routines (15%). The respondents suggested that the following measures should be prioritized to increase the treatment's use: educational programmes to improve public awareness on stroke and how to respond (96%); education of in-hospital (88%) and prehospital (76%) medical staff.


CONCLUSIONS
A large majority of Scandinavian doctors regard thrombolytic treatment for stroke as beneficial, yet its implementation in clinical practice has so far been poor. Our survey identified important barriers and potential measures that could increase its future use.
Slot
K Bruins
KB
Department of Internal Medicine, Ullevaal University Hospital, Oslo, Norway. karsten.bruins.slot@medisin.uio.no
Murray
V
V
Boysen
G
G
Berge
E
E
D003625:Data Collection; D003695:Delivery of Health Care; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006306:Health Surveys; D006801:Humans; D010358:Patient Participation; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012537:Scandinavian and Nordic Countries; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D015912:Thrombolytic Therapy / Q000379:methods* / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome
D005343:Fibrinolytic Agents