A systematic review of the effectiveness, cost-effectiveness and barriers to implementation of thrombolytic and neuroprotective therapy for acute ischaemic stroke in the NHS

Sandercock P, Berge E, Dennis M, Forbes J, Hand P, Kwan J, Lewis s, Lindley R, Neilson A, Thomas B, Warlaw J
Record ID 32002000893
English
Authors' objectives:

The objectives of the current report are:

- To assess the effectiveness of thrombolytic drugs. - To assess the effectiveness of neuroprotective drugs. - To map current pathways of acute stroke care, identify barriers to implementation of emergency drug treatments for acute stroke in the NHS, and to suggest solutions to overcome these barriers. - To model the health economic impact of thrombolytic therapy.

Authors' recommendations: Thrombolytic drugs: The data available are limited and the estimates of effectiveness and cost-effectiveness are imprecise. The data were judged to be insufficient to provide reliable estimates of the cost of modifying NHS services for patients with acute stroke to enable rt-PA to be delivered safely and effectively within the NHS. In the authors opinion, the data do not, therefore, support the widespread use of thrombolytic therapy in routine clinical practice in the NHS. Neuroprotective drugs: An agent associated with even modest benefit is likely to be cost-effective, but none is available yet. Barriers: The cost of overcoming the known barriers to acute stroke treatment is likely to vary from centre to centre and will depend chiefly on the baseline level of stroke service provision.
Authors' methods: Systematic review
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk/1127
Year Published: 2002
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Cerebrovascular Disorders
  • Costs and Cost Analysis
  • Neuroprotective Agents
  • Thrombolytic Therapy
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.