Multicenter exploration of tenecteplase transition factors: A quantitative analysis

Area of Science:

• Neurology
• Pharmacology
• Healthcare Management

Background:

• Tenecteplase (TNK) is emerging as a novel therapy for acute ischemic stroke (AIS).
• TNK offers advantages over Alteplase (ALT), including a longer half-life and potential time/cost savings.
• However, hospital systems face challenges in adopting TNK for AIS treatment.

Purpose of the Study:

• To identify barriers and facilitators influencing the implementation of TNK at acute care hospitals in Texas.
• To inform strategies for successful TNK adoption in clinical practice.

Main Methods:

• A prospective survey was conducted among stroke clinicians and nurses at 40 Texas hospitals.
• The survey utilized open-ended questions and Likert statements, informed by expert content and qualitative research.
• Data was collected via a virtual platform.

Main Results:

• Hospitals surveyed varied in size, with 50% designated as Comprehensive Stroke Centers.
• Alteplase (ALT) was the sole treatment for eligible AIS patients in 45% of hospitals.
• Facilitators included clinician and pharmacist buy-in; barriers included perceived lack of robust clinical evidence and insufficient American Heart Association guideline support for TNK.

Conclusions:

• Understanding barriers and facilitators is crucial for hospitals considering TNK implementation for AIS.
• The findings will guide the development of a TNK adoption Toolkit using implementation science.
• This toolkit aims to overcome identified obstacles and leverage existing facilitators for successful TNK integration.