According to a study published in the August issue of Neurology, using standardized forms at the time stroke patients are admitted to and discharged from the hospital can improve care of the stroke patients significantly.
Studies have shown that several treatments for stroke patients reduce the amount of disability, complications and the risk of having another stroke. The treatments are for people with ischemic stroke. Despite this evidence and recommendations, these treatments are not used as often as they could be due to oversight or lack of awareness.
Care of stroke patients is complicated, and the evidence is growing rapidly. Researchers for the study from the University of California, San Francisco said that it's difficult for busy clinicians to keep up with proven best practices, and things can fall through the cracks.
In an effort to increase the use of these treatments, six California hospitals in the study developed standardized forms for use when stroke patients were admitted to and discharged from the hospital. The forms included the recommended treatments. The treatments are: using a clot-busting treatment within three hours of the start of the stroke; preventive treatment for blood clots in the leg veins; drugs that prevent blood clots from forming within 48 hours of arrival at the hospital and at discharge; cholesterol-lowering drugs at discharge; and smoking cessation counseling.
If the treatment was not used, the forms included boxes to check for acceptable reasons for not using the treatment, such as not using a clot-busting drug for a patient who arrived at the hospital more than three hours after the first symptoms or not using cholesterol-lowering drugs for a patient who already had low cholesterol.
The treatment stroke patients received in the year after the new forms were implemented were compared to the treatment they received in the year before the forms were implemented. During that time, 413 patients were treated in the six hospitals.
Overall, patients were more likely to receive optimal treatment after the forms were implemented than before. Optimal treatment was defined as receiving all of the recommended treatments unless there was an appropriate reason not to receive a treatment.
Researchers said that the study shows that it is feasible to significantly improve stroke treatment. However, he noted that the researchers couldn't be certain that use of the forms led to the improvement. All hospitals were aware that these measures were being monitored, and there were many discussions about the treatments, the researchers commented.