Monday, February 2, 2009

New study finds Get With the Guidelines program improves stroke outcomes
By Kelly Winget, DCRI Communications

Although numerous evidence-based guidelines have been published about how to improve stroke outcomes, many stroke patients were still not receiving optimal care. However, a new study found that centers that participate in the Get With the Guidelines (GWTG)—Stroke program experience significant improvement in these outcomes.

The DCRI's Wenqin Pan, PhD, Li Liang, PhD, and Eric Peterson, MD, MPH, were involved with the study and the DCRI served as the data analysis center. The study results appear in the January 6/13 issue of Circulation.

Researchers reviewed patient data from hospitals that voluntarily participated in the GWTG--Stroke program to determine if participating in the program helped hospitals better adhere to stroke care guidelines.

Medical complications that happen while patients are hospitalized for stroke can limit patients' functionality when they are released. The GWTG--Stroke program focuses on low-cost treatments that have been found to lower the rate of repeat strokes and improve patient outcomes.

Beginning in April 2003, hospitals in selected states were asked to participate in the GWTG--Stroke program, and in 2004, the program expanded to all U.S. hospitals that were interested in participating. The goals were to improve in seven key areas: intravenous treatment with an anti-blood clot drug (tPA) in patients who arrive at the hospital less than two hours after the first signs of stroke; prescribing anti-blood clot medication within 48 hours of hospital admission; treatment for deep vein thrombosis (blood clots in muscles that can be life-threatening) within 48 hours of hospital admission in patients who can't walk around; discharging patients with antithrombotic medication to help break up blood clots; discharging patients who have atrial fibrillation with an anticoagulant to prevent blood clots from forming; treating patients for high levels of low-density lipoprotein (“bad” cholesterol) who meet the National Cholesterol Education Program Adult Treatment Panel guidelines; and providing counseling or medication to help patients quit smoking.

Researchers found that hospitals participating in GWTG—Stroke improved in all of the key areas. The longer a hospital participated in the program, the more significant the improvements in adhering to stroke guidelines. Improvements were seen in hospitals regardless of hospital size, location or status as a teaching hospital. However, researchers did find that the biggest improvements were in larger hospitals and hospitals that have larger numbers of stroke patients discharged from the hospital.

Click here to read the full article.