BMJ  2006;333:656 (23 September), doi:10.1136/bmj.333.7569.656-a

Letter

Ageism in services for transient ischaemic attack and stroke

Clinical leadership is key in changing practice

The first 150 words of the full text of this article appear below.

EDITOR—Fairhead and Rothwell report substantial underinvestigation in routine clinical practice in elderly patients with transient ischaemic attack and stroke.¹ We found that brain imaging was performed only in a small proportion of older patients admitted with acute stroke.

The most common misconceptions were that imaging older adults after an acute stroke would not change management and therefore was a waste of resources. After the appointment of a clinical lead in stroke, we changed this practice by a continuing audit cycle, development of local acute stroke guidelines, and regular teaching sessions on the importance of appropriate prescribing of antiplatelet agents, risk of haemorrhage with indiscriminate use of antiplatelet agents, consequences of recurrent stroke, and prevention especially in older patients. The table shows that this sustained effort improved the rate of brain imaging in older patients.

View this table: [in this window] [in a new window]   Rates of brain imaging in patients admitted with acute stroke in 1997, 1998, and . . . [Full text of this article]

 

Peterborough and Stamford NHS Hospitals Trust, Edith Cavell Hospital, Peterborough PE3 9GZ sunku.guptha@pbh-tr.nhs.uk

Peterborough and Stamford NHS Hospitals Trust, Edith Cavell Hospital, Peterborough PE3 9GZ

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Underinvestigation and undertreatment of carotid disease in elderly patients with transient ischaemic attack and stroke: comparative population based study

Jack F Fairhead and Peter M Rothwell
BMJ 2006 333: 525-527. [Abstract] [Full Text] [PDF]