Barriers to delivery of tissue plasminogen activator for patients with acute ischemic stroke

Stroke is the third leading cause of death and the first leading cause of disability worldwide. The tissue plasminogen activator (TPA) is one of the few treatments for this condition, which is currently used at a limited number of medical centers in Iran. Since the TPA is not used in Qazvin City, Iran, this study aimed to determine the frequency of qualified recipients to receive the TPA and the preventive factors associated with the use of the drug at the Boo Ali Center (Qazvin, Iran). In this case study, 100 patients with the acute cerebral ischemic attack admitted to Boo-Ali hospital were selected during a six-month period (March to September 2014). The patients were evaluated for receiving the TPA using a questionnaire and then the data were analyzed. Only 8% of the patients were qualified to receive the TPA. the main preventing factors in drug delivery with the highest rates were delay in visiting by a neurologist (75%), delay in referring the patients to the medical centers (67%), delay in preparing the clinical tests (46%), delay in visiting by an emergency department physician (39%), delay in preparing the CT scan result (36%), using the anti-platelets (35%), and anticoagulants (26%), respectively. Due to several preventive factors in the delivery of the drug, only a limited percentage of the patients were qualified to receive the TPA. More studies are needed to identify the causes and obviate them.