title: Agreement with evidence for tissue Plasminogen Activator use among emergency physicians: a cross-sectional survey.
abstract: BACKGROUND
  Emergency department staff play a crucial role in the triage of stroke patients and therefore the capacity to deliver time-dependent treatments such as tissue Plasminogen Activator. This study aimed to identify among emergency physicians, (1) rates of agreement with evidence supporting tissue Plasminogen Activator use in acute stroke care; and (2) individual and hospital factors associated with high agreement with evidence supporting tissue Plasminogen Activator use.
  
  
  METHODS
  Australian fellows and trainees of the Australasian College for Emergency Medicine were invited to complete an online cross-sectional survey assessing perceptions of tissue Plasminogen Activator use in acute stroke. Demographic and hospital characteristics were also collected.
  
  
  RESULTS
  429 Australasian College for Emergency Medicine members responded (13% response rate). Almost half (47.2%) did not agree with any statements regarding the benefits of tissue Plasminogen Activator use for acute stroke. Perceived routine administration of tissue Plasminogen Activator by the head of respondents' emergency department was significantly associated with high agreement with the evidence supporting tissue Plasminogen Activator use in acute stroke.
  
  
  CONCLUSIONS
  Agreement with evidence supporting tissue Plasminogen Activator use in acute stroke is not high among responding Australian emergency physicians. In order for tissue Plasminogen Activator treatment to become widely accepted and adopted in emergency settings, beliefs and attitudes towards treatment need to be in accordance with clinical practice guidelines.
authors.affiliation: Priority Research Centre for Health Behaviour, Hunter Medical Research Institute (HMRI), University of Newcastle, Callaghan, NSW, 2308, Australia. Alice.Grady@newcastle.edu.au.
authors.forename: Alice M
authors.initials: AM
authors.lastname: Grady
authors.affiliation: Priority Research Centre for Health Behaviour, Hunter Medical Research Institute (HMRI), University of Newcastle, Callaghan, NSW, 2308, Australia. Jamie.Bryant@newcastle.edu.au.
authors.forename: Jamie
authors.initials: J
authors.lastname: Bryant
authors.affiliation: Priority Research Centre for Health Behaviour, Hunter Medical Research Institute (HMRI), University of Newcastle, Callaghan, NSW, 2308, Australia. Mariko.Carey@newcastle.edu.au.
authors.forename: Mariko L
authors.initials: ML
authors.lastname: Carey
authors.affiliation: Priority Research Centre for Health Behaviour, Hunter Medical Research Institute (HMRI), University of Newcastle, Callaghan, NSW, 2308, Australia. Chris.Paul@newcastle.edu.au.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Paul
authors.affiliation: Priority Research Centre for Health Behaviour, Hunter Medical Research Institute (HMRI), University of Newcastle, Callaghan, NSW, 2308, Australia. Rob.Sanson-Fisher@newcastle.edu.au.
authors.forename: Rob W
authors.initials: RW
authors.lastname: Sanson-Fisher
authors.affiliation: Department of Neurology, John Hunter Hospital, New Lambton, NSW, 2305, Australia. Christopher.Levi@hneheath.nsw.gov.au.|Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, NSW, 2308, Australia. Christopher.Levi@hneheath.nsw.gov.au.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Levi
mesh_terms: D000208:Acute Disease; D000328:Adult; D001315:Australia; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000592:standards*; D004636:Emergency Service, Hospital; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D017410:Practice Guidelines as Topic; D020521:Stroke / Q000188:drug therapy* / Q000473:pathology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator