Attitude and Knowledge of Emergency Medicine Professionals Regarding the Use of Tissue Plasminogen Activator in the Treatment of Acute Ischemic Stroke: A Cross-Sectional Study

Mahsa Ziaee; Zahra Mirza Asgari; Mojtaba Chardoli; Soodabeh Hoveidamanesh; Babak Zamani; Marjan Zeinali; Mostafa  Almasi-Dooghaee

doi:10.18502/jimc.v5i2.10467

Mahsa Ziaee Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Zahra Mirza Asgari Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Mojtaba Chardoli Hazrat Rasool Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Soodabeh Hoveidamanesh Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
Babak Zamani Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Marjan Zeinali Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Mostafa Almasi-Dooghaee Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v5i2.10467

Keywords: Acute ischemic stroke, Attitude, Emergency medicine, Knowledge, Physicians, Tissue plasminogen activator

Abstract

Background: One of the main parts of the early treatment of Acute Ischemic Stroke (AIS) is the attitude and knowledge of Emergency Medicine (EM) specialists. This study aimed to investigate the knowledge and attitude of emergency physicians working in Iran about the prescription of tissue Plasminogen Activator (tPA) in AIS.

Methods: This was a cross-sectional questionnaire-based study including EM physicians working in different cities of Iran in 2020. A previously used English questionnaire was translated into Persian. After face validity and reliability assessment, the final questionnaire was designed as a Google form and sent to 400 EM professionals.

Results: 128 physicians filled in the forms. 64.8% of participants had sufficient attitude and 68% had sufficient knowledge about tPA treatment in AIS. The knowledge regarding tPA treatment was higher in the age>40 years, male gender and physicians with up-to-date information (P<0.05), but no significant association was found for the attitude. Logistic regression analysis showed that the amount of information about tPA administration in AIS (OR=3.475, 95% CI =1.242-9.723, p=0.018) and age (OR=0.336, 95% CI = 0.130-0.865, p=0.024) had the greatest impact on the level of knowledge for tPA treatment.

Conclusion: About two-thirds of EM professionals in Iran had sufficient knowledge and attitude about tPA administration in AIS. Having up-to-date information and age>40 years were the major predictors of higher knowledge of AIS treatment. Holding some training workshops together with strengthening infrastructures such as establishing intensive stroke units would help to increase the use of tPA in AIS in Iran.