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A closer look at clot-busters

Yale Medicine Magazine, 2003 - Winter

Contents

Clot-busting drugs are almost always administered to stroke patients incorrectly, sometimes with serious consequences, according to a recent Yale study.

Researchers reviewed the medical records of 63 patients who received thrombolytic therapy between 1996 and 1998. They found departures from recommended practice 97 percent of the time. “Major deviations from protocol were present in two-thirds of the cases and were associated with serious or fatal consequences,” said Dawn M. Bravata, M.D., principal investigator of the study published in the Archives of Internal Medicine.

Errors ranged from incorrect dosages and delays in administering the drugs to giving them to at-risk patients. Responsibility for the drugs’ misuse was widespread, the study found, and detours from protocol occurred all along the heath care pathway. Why? “It’s a hard drug to give properly,” Bravata said. “It’s not something doctors do every day.”

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