Telemedicine in Stroke Management

Project lead: Tim Johansson
Duration: November 2008 - August 2009

Literature search and -documentation: Tarquin Mittermayr
Suggested by: SALK, dissertation
Publication: HTA Project Report 29 - https://eprints.aihta.at/844

Background:
Acute stroke is the single biggest cause of major disability and is ranked as the second or third leading cause of death in most industrialised countries. Strokes often lead to disabilities of different type and severity, where in the majority of cases a cost-intensive long-term rehabilitation is needed. For more than a decade, two treatments for stroke patients have been shown to be effective: stroke-units (specialised centres) and systemic thrombolytic therapy for ischemic strokes. The problem is, however, that very few stroke patients have access to these therapeutic options. Reasons for this situation are the lack of experts and experience, especially in non-urban areas, as well as the very limited time available/left after onset for using a systemic thrombolytic therapy. Telemedicine methods can expand the knowledge and experiences from stroke units, and improve the delivery of systemic thrombolytic therapy for ischemic stroke patients. It is evident that the rehabilitation is most effective when it begins as soon as possible after stroke care. Different telemedicine methods have been described in the literature and also for the implementation in rehabilitation settings for stroke patients (e.g. home-based rehabilitation, Internet-based support to rural caregivers). Telemedicine methods may be important instruments in the organisation of rehabilitation services in order to improve the quality of stroke management.

Aims and research objectives:
The aim of the project is twofold. On the one hand to explore the effectiveness, quality and cost (cost-effectiveness) of telemedicine technologies in stroke management, and on the other hand to explore the effectiveness, quality and cost-effectiveness of interventional therapies in acute stroke management.

Method:
Systematic review and literature search of telemedicine technologies in stroke care management and interventional therapies in stroke.