Hospital based program launched to improve outcomes for stroke patients in China to impact world's largest population

The program works to improve treatment for, and prevention of, cardiovascular and stroke events by helping hospitals and providers consistently adhere to the latest scientific treatment guidelines. In the last 15 years, Get With The Guidelines has transformed patient care for heart and stroke patients in the U.S., helping hospitals and providers learn the correct treatment and translate guidelines into practice. This program has saved lives and resulted in more than 400 scientific publications that advance heart and brain health around the world.

The adapted Get With The Guidelines program, designed through a collaboration of the ASA and the CSA, endorsed by the China National Health and Family Planning Commission, and supported by Medtronic, is a set of "best practices" that aim to continuously improve treatment, enhance the quality of care, and prevent future stroke events in China.

While several evidence-based, highly effective, guideline-recommended therapies are known, adherence to guidelines for stroke care remains incomplete and highly variable from region to region, and country to country.

This effort aims to solve for that in China. Specifically, this program addresses the need for:

1.     Enhanced education for EMS and pre-hospital caregivers, especially since analysis shows only 13 percent of Chinese stroke patients arrive at the hospital by EMS, versus 50 percent in the U.S.

2.     A reduction in "door-to-needle" times for patients to receive the clot-busting drug tPA. To-date, analysis for rates of compliance with evidenced based therapies notes significant gaps in timeliness to tPA treatment.

3.     Increased awareness and application of mechanical endovascular reperfusion therapies in appropriate patients.

4.     Increased awareness and application of secondary prevention in appropriate stroke patients to fill significant gaps in venous thromboembolism (VTE) prophylaxis, lipid lowering therapy, anticoagulation for atrial fibrillation and rehabilitation assessment in Chinese patients.

With a population of 1.4 billion, stroke is the leading killer and claims the lives of 1.6 million Chinese people annually. Today, China faces cardiovascular and stroke risk factors similar to those in Western nations. Among risk factors, hypertension remains the most important for all types of strokes.[1] Additionally, the concept of a "stroke belt" in China has emerged which identifies specific geographic regions where the mortality associated with stroke is 50 percent higher than that of other regions in the country. Currently, the areas with higher mortality are the northeast and the western/southwestern.[2]

In 2007, the Ministry of Health -- now National Health and Family Planning Commission -- sponsored the Chinese National Stroke Registry and a five-year plan to increase comprehensive stroke centers in China. Establishing the registry also led to creating the Stroke Screening, Prevention and Treatment Project in 2009, and more recently the National Center of Stroke Care Quality Control in 2011.

"The American Stroke Association is deeply committed to having a transformative impact on healthcare systems and patients worldwide by working alongside countries, governments and international cardiovascular and cerebrovascular societies to facilitate the application of the tools and knowledge of our quality programs," said Ying Xian, M.D., Ph.D, American Stroke Association spokesperson and Assistant Professor of Neurology and Medicine at the Duke University Medical Center and Duke Clinical Research Institute. "The U.S. marketplace has given us a road map to develop scalable and sustainable models for international quality improvement initiatives. Now, with our consult, the Chinese Stroke Association aims to adopt those models to achieve better outcomes for stroke patients in China."

"It is with great excitement that we announce the launch of this collaborative stroke quality improvement project between the CSA and ASA to further enhance cooperation on clinical research, education, and the impact of acute stroke science," said Jizong Zhao, President, CSA. "I congratulate both organizations' dedication to improving stroke outcomes in China."

Reaching healthcare providers with the Get With The Guidelines program at Chinese secondary and tertiary hospitals -- and at all stages of the chain of survival, from pre-hospital advanced medical care (also known as EMS or emergency medical services) to neurologists to even hospital administrators -- is the priority.

"Medtronic is a leading stroke care solution provider in stent retriever therapy with more than 20 years of experience in China. We provide clinical education and training systems for Chinese physicians and, together with medical societies, we consistently promote a hierarchical treatment system, raise public awareness, and speed up patient admission and treatment to ensure the proper care for patients," said Chris Lee, President, Medtronic Greater China. "We are very proud to collaborate with both the CSA and ASA, and we will continuously work together to improve China's stroke care quality."

Stroke has also had a significant impact on healthcare expenditures and the Chinese economy. The cost for stroke care by the government-funded hospitals was 1.17 billion RMB (approx. $170M USD) in 2003 and 8.19 billion RMB (approx. $1.3B USD) in 2009, a 117 percent increase annually. Now, the annual cost of stroke care in China is approximately 40 billion RMB ($5.8B USD).[3]

[1] http://stroke.ahajournals.org/content/42/12/3651

[2] http://stroke.ahajournals.org/content/strokeaha/44/7/1775.full.pdf

[3] http://stroke.ahajournals.org/content/42/12/3651     

About the American Heart Association and American Stroke Association

The American Heart Association and the American Stroke Association are devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based American Heart Association is the nation's oldest and largest voluntary organization dedicated to fighting heart disease and stroke. The American Stroke Association is a division of the American Heart Association. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

SOURCE American Heart Association