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A qualitative study of barriers and facilitators to using tenecteplase to treat acute ischemic stroke.

Authors :
Prasad, Sidarrth
Jones, Erica M.
Gebreyohanns, Mehari
Aguilera, Veronica
Olson, DaiWai M.
Anderson, Jane A.
Savitz, Sean I.
Flores, Salvador C.
Warach, Steven J.
Rhodes, Charlotte E.
Goldberg, Mark P.
Ifejika, Nneka L.
Source :
Journal of Stroke & Cerebrovascular Diseases; Jan2024, Vol. 33 Issue 1, pN.PAG-N.PAG, 1p
Publication Year :
2024

Abstract

Tenecteplase (TNK) is emerging as an alternative to alteplase (ALT) for thrombolytic treatment of acute ischemic stroke (AIS). Compared to ALT, TNK has a longer half-life, shorter administration time, lower cost, and similarly high efficacy in treating large vessel occlusion. Nevertheless, there are barriers to adopting TNK as a treatment for AIS. This study aimed to identify thematic barriers and facilitators to adopting TNK as an alternative to ALT as a thrombolytic for eligible AIS patients. Qualitative research methodology using hermeneutic cycling and purposive sampling was used to interview four stroke clinicians in Texas. Interviews were recorded and transcribed verbatim. Enrollment was complete when saturation was reached. All members of the research team participated in content analysis during each cycle and in thematic analysis after saturation. Interviews were conducted between November 2022 and February 2023 with stroke center representatives from centers that either had successfully adopted TNK, or had not yet adopted TNK. Three themes and eight sub-themes were identified. The theme "Evidence" had three sub-themes: Pro-Con Balance, Fundamental Knowledge , and Pharmacotherapeutics. The theme "Process Flow" had four subthemes: Proactive, Reflective self-doubt, Change Process Barriers, and Parameter Barriers. The theme "Consensus" had one sub-theme: Getting Buy-In. Clinicians experience remarkably similar barriers and facilitators to adopting TNK. The results lead to a hypothesis that providing evidence to support a practice change, and identifying key change processes, will help clinicians achieve consensus across teams that need to 'buy in' to adopting TNK for AIS treatment. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
10523057
Volume :
33
Issue :
1
Database :
Supplemental Index
Journal :
Journal of Stroke & Cerebrovascular Diseases
Publication Type :
Academic Journal
Accession number :
174498477
Full Text :
https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107458