JACKOVÁ, Jana, Petra ŠEDOVÁ, Robert D BROWN, Tomáš BRYNDZIAR, Miroslav ZVOLSKY, Josef BEDNAŘÍK and Robert MIKULÍK. The High Frequency of Guideline-Approved and Guideline-Disapproved Medication Use in Stroke and Transient Ischemic Attack. Journal of Stroke & Cerebrovascular Diseases. Amsterdam: Elsevier Science Inc., 2016, vol. 25, No 11, p. 2688-2693. ISSN 1052-3057. Available from: https://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.07.016.
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Basic information
Original name The High Frequency of Guideline-Approved and Guideline-Disapproved Medication Use in Stroke and Transient Ischemic Attack
Authors JACKOVÁ, Jana (703 Slovakia, belonging to the institution), Petra ŠEDOVÁ (203 Czech Republic, belonging to the institution), Robert D BROWN (840 United States of America), Tomáš BRYNDZIAR (703 Slovakia, belonging to the institution), Miroslav ZVOLSKY (203 Czech Republic), Josef BEDNAŘÍK (203 Czech Republic, belonging to the institution) and Robert MIKULÍK (203 Czech Republic, guarantor, belonging to the institution).
Edition Journal of Stroke & Cerebrovascular Diseases, Amsterdam, Elsevier Science Inc. 2016, 1052-3057.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30000 3. Medical and Health Sciences
Country of publisher Netherlands
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.517
RIV identification code RIV/00216224:14110/16:00092397
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.07.016
UT WoS 000389520800023
Keywords in English cost-effectiveness; Czech Republic; evidence-based; guidelines; pharmacotherapy; Stroke
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 26/4/2017 12:31.
Abstract
Abstract BACKGROUND AND PURPOSE: Administration of evidence-based pharmacotherapy improves stroke outcome while the use of non-evidence-based medications may not be of benefit and leads to unnecessary patient care costs. The aim of our study was to determine the frequency of guideline-approved and guideline-disapproved pharmacotherapy use in acute stroke management in the Czech Republic (CR). METHODS: Using the ICD-10 codes, 500 stroke and transient ischemic attack (TIA) patients were randomly selected (random selection of 10 hospitals and then 50 patients from each hospital) from the National Registry of Hospitalized Patients for strokes occurring in 2011. Discharge summaries were reviewed for medications prescribed during hospitalization and at discharge. RESULTS: Of the 500 requested discharge summaries, 484 were available for review (response rate 97%). Up to 479 (96%) summaries were sufficient for evaluation and of these, 393 were confirmed to have a stroke or TIA diagnosis. Brain imaging (computed tomography or magnetic resonance imaging) was performed in 97% of the 393 cases. Intravenous thrombolysis was administered to 7% of patients with ischemic stroke (rate was 0%-25% in different hospitals). Up to 97% of patients with ischemic events (TIA or ischemic stroke) were treated with antiplatelets or anticoagulants. At least 1 non-evidence-based medication was administered to 28% of the 393 patients (rate was 5%-89% in different hospitals). CONCLUSIONS: Guideline-disapproved pharmacotherapy is common in stroke and TIA patients in the CR and processes should be put into place to lessen the frequency of their use. The use of guideline-approved medications is also high and should be further promoted.
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