Abstract
BackgroundTranslating clinical guidelines into routine clinical practice is mandatory to achieve population level improvement of health. Emergence of specific therapy for acute stroke yielded the ‘time is brain’ concept introducing the need for emergency treatment, pointing to the need for increasing stroke awareness of the general population. General practitioners (GPs) manage chronic diseases and could hence catalyse stroke awareness. In our study, the knowledge of general practitioners toward accurate identification of acute stroke candidacy was investigated.MethodsGPs and residents in training for family medicine participated in a survey on a voluntary basis using supervised self-administration between the 1st of February 2018 and 31st July 2018. Two clinical cases of acute stroke that differed only regarding the patient’s eligibility for intravenous thrombolysis were presented. Participants answered two open-ended questions. Text analysis was performed using NVIVO software.ResultsOf the 127 respondents, 69 (54.3%) were female. The median age was 49 (34–62) years. The median time spent working after graduation was 14.5 (2–22.5) years. Board-certified GPs made up 77.2% of the sample. Qualitative analysis revealed stroke as the most frequent diagnosis for both cases. Territorial localization and possible aetiology were also established. Respondents properly identified eligibility for thrombolysis. Quantitative assessment showed that having the practice closer to the stroke centre increases the likelihood of adequate diagnosis for acute stroke.ConclusionsOur results show that GPs properly diagnose acute stroke and identify intravenous thrombolysis candidates. Moreover, we found that a vigorous acute stroke triage system facilitates the translation of theory into practice.
Highlights
Translating scientific evidence into clinical practice is fundamental to attain population level positive health outcomes [1]
The median years spent working after graduation was 14.5 (2–22.5) years; 98 (77.2%) physicians had board certification in family medicine and the remaining 29 (22.8%) were enrolled in the residency training programme for family medicine
The word ‘acute’ was only within the top 10 most frequent words for Clinical Case 1 describing a thrombolysis candidate, while the diagnosis for Clinical Case 2 was differentiated by frequent mentions of ‘outside’ and ‘time window’
Summary
Translating scientific evidence into clinical practice is fundamental to attain population level positive health outcomes [1]. A. The past decade witnessed a paradigm shift in acute stroke management as stroke became acknowledged as an emergency. The past decade witnessed a paradigm shift in acute stroke management as stroke became acknowledged as an emergency This was paralleled by the availability of specific treatment by means of intravenous thrombolysis, yielding the ‘time is brain’ concept [7]. Intravenous administration of recombinant tissue plasminogen activator is indicated in ischemic stroke within a limited time window of 4.5 h [8]. This has triggered the organization of triage systems focusing on prehospital emergency. The knowledge of general practitioners toward accurate identification of acute stroke candidacy was investigated
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