Invited Commentary

Commentary on "Advice on Stroke Provided by Pharmacies in the United States: Implications for Treatment and Care"

Authors: Earnest Lee Murray, MD

Abstract

The treatment of acute ischemic stroke (AIS) during the past several years has made significant strides with the use of recombinant tissue plasminogen activator (rt-PA). rt-PA is the most readily available treatment for AIS, which can be given in small and large hospitals, and is one of only a limited number of treatment options affording an AIS patient the best chance of reversal of stroke symptoms or minimizing a stroke’s effects. Although the use of rt-PA has increased since its inception, only 3% to 5% of patients with AIS in the United States receive rt-PA.1 The biggest obstacle to more patients being offered rt-PA in AIS is arriving at a facility that is capable of administering the drug within the narrow timeframe from symptom onset. Several variables come into play when attempting to maximize the patient’s recovery potential. The patient and his or her family, emergency medical services (EMS), ancillary medical professionals, and nursing and physicians regardless of specialty must act quickly and in concert for the patient to achieve the best possible outcome.

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References

1. Adeoye O, Hornung R, Khatri P, et al. Recombinant tissue-type plasminogen activator use for ischemic stroke in the United States: a doubling of treatment rates over the course of 5 years. Stroke 2011;42:1952-1955.
 
2. Adeoye O, Lindsell C, Broderick J, et al. Emergency medical services use by stroke patients: a population-based study. Am J Emerg Med 2009;27:141-145.
 
3. Kesinger MR, Sequeira DJ, Buffalini S, et al. Comparing national institutes of health stroke scale among a stroke team and helicopter emergency medical service providers. Stroke 2015;46:575-578.
 
4. Adeoye O, Albright KC, Carr BG, et al. Geographic access to acute stroke care in the United States. Stroke 2014;45:3019-3024.
 
5. Monseau A, Whiteman A, Crocco TJ, et al. Advice on stroke provided by pharmacies in the United States: implications for treatment and care. South Med J 2015;108:219-222.