Hospital referral of stroke patients: a survey of attitudes in general practice, and consideration of entry times for clinical trials

Autor: L. Hantson, Jacques De Keyser, Luc Tritsmans, Jan Gheuens
Přispěvatelé: Gerontology
Jazyk: angličtina
Rok vydání: 1994
Předmět:
Adult
Male
Pediatrics
medicine.medical_specialty
Stroke patient
Referral
Attitude of Health Personnel
Home Nursing
Cross-sectional study
Referral and Consultation/*statistics & numerical
atient Care Team/*statistics & numerical data
Patient Admission/statistics & numerical data
Middle Age
Patient Admission
Belgium
80 and over
Humans
Medicine
Referral and Consultation
Stroke
Belgium/epidemiology
Aged
Retrospective Studies
Aged
80 and over

Patient Care Team
Neurologic Examination
Clinical Trials as Topic
business.industry
Vascular disease
Clinical Trials/*statistics & numerical data
Home Nursing/psychology/statistics & numerical dat
Retrospective cohort study
General Medicine
Middle Aged
Cerebrovascular Disorders/*epidemiology/psychology
medicine.disease
Middle age
Clinical trial
Cerebrovascular Disorders
Cross-Sectional Studies
incidence
Surgery
Female
Neurology (clinical)
business
Family Practice
Human
Popis: Two major issues in clinical trials in stroke are the criteria used for the selection of patients expected to benefit from the proposed treatment, and the entry time of those patients. We surveyed 507 Belgian general practitioners (GPs) on their opinions on referral of stroke patients to hospital and also on their actual referral behaviour. The feasibility of a 6-hour entry time was included in the investigation. Stroke is considered to require an urgent response: 88% of GPs visited the patient immediately on concluding that such an event had occurred. The mean time between the onset of the first clinical symptoms and the arrival of the GP at the patient's residence was about 30 minutes. Within 6 h of the insult, 95% of the patients referred to hospital had been admitted. Information on the GP's most recent stroke patient revealed that 72.4% of these stroke patients were admitted to hospital. Patients referred to hospital were significantly younger, had a significantly more severe stroke, and were significantly more likely to have had a first stroke and to have lived independently before the insult than patients not admitted to hospital. We think that Belgian GPs need to change their referral behaviour with respect to stroke patients and refer more of those who have suffered more mildly, There is every reason to be optimistic about this re-education, since the patients whom GPs do refer to hospital are referred rapidly enough to profit from a possibly efficacious treatment.
Databáze: OpenAIRE