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• W1648283570 abstract "Background: Stroke is a leading cause of death and adult neurological disability in Canada. To understand the treatment of stroke in Canada, the attitudes and practices of 3 types of physicians who treat acute stroke were explored (university-based neurologists who specialize in stroke, community-based neurologists, and general and family practitioners who work in emergency departments in small, nonurban hospitals). Methods: Qualitative, key-informant research was conducted through focus groups. Comments and individual reports of focus group members were analysed to examine underlying attitudes toward stroke, care of patients with acute stroke, new stroke treatments such as tissue-plasminogen activator (t-PA), different forms of continuing medical education related to stroke, and the concept of stroke centres. Results: Among the 3 groups of physicians, attitudes varied significantly regarding the ability to treat stroke, the potential of t-PA in acute stroke care, and the utility of stroke centres. University-based neurologists were generally enthusiastic about the use of t-PA as a treatment for stroke and the potential for increasing awareness about stroke treatment among other physicians. Community-based neurologists held a more conservative view concerning the effectiveness of t-PA and the ability to treat patients with stroke, and nonspecialist physicians in small community-hospital emergency departments regarded t-PA as an impractical therapy given their settings. Interpretation: Stroke care appears to vary across the province according to the type of institution and clinician. Differences in attitudes regarding the treatability of stroke and the potential of t-PA to help patients with acute stroke are largely a function of the institutional resources available. At present, academic centres that specialize in stroke are among the few places in Ontario where patients with stroke have ready access to neurologic consultation and computed tomography (CT) scanning, both of which are necessary for t-PA to be used. In most community hospitals, both neurologic consultation and CT scanning may not be readily available, and emergency department physicians treat acute stroke in a highly individualized manner. Physicians in these settings may not view t-PA as a viable therapy for stroke." @default.
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• W1648283570 date "1998-09-22" @default.
• W1648283570 modified "2023-09-24" @default.
• W1648283570 title "Are physicians ready for thrombolysis for acute stroke? A qualitative study" @default.
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