Authors' objectives:

This report addresses the following questions:

1. Is thrombolysis cost-effective?

2. What proportion of patients is getting the full benefits?

3. What can be done to facilitate the giving of thrombolysis in the community?

4. Which drug is best?

5. Should thrombolysis treatment be given only in communities distant from hospital?

Authors' recommendations: Thrombolysis is a valuable, life-saving, and highly cost-effective treatment. It is under-used in Scotland, and heart disease mortality is therefore higher than it need be. The earlier it is given, the more effective it is. There is a great opportunity here for general practitioners to make a significant contribution to heart disease mortality, by giving thrombolysis in the community. However the difficulties in the field should not be underestimated, and whenever possible both GP and ambulance should attend lest there be a need for resuscitation. Outside hospital, the drug of choice is at present urokinase. Inside hospital, it is streptokinase for all but those who have had it before. Newer and more expensive drugs such as alteplase are not worthwhile as first-line treatment in hospital because the marginal cost per life saved is very high. General practitioners should be strongly supported in the giving of thrombolysis by management and by hospital cardiologists.

Authors' methods: Overview

Project Status: Completed

URL for project: http://www.nhsconfed.net/shpic/doc13.htm

Year Published: 1997

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Scotland, United Kingdom

Organisation Name: Scottish Health Purchasing Information Centre

Copyright: Scottish Health Purchasing Information Centre