October 16, 2013
Proper And Timely Medical Help Often Lacking For Stroke Victims
April Flowers for redOrbit.com - Your Universe Online
Researchers in the UK have found that a majority of people diagnosed as having suffered a minor stroke or transient ischaemic attack (TIA) do not seek medical help in the timeframe recommended by the Royal College of Physicians.
The study, published online in the journal Age and Ageing, found that of over 270 patients, only a small minority acted in a timely manner, despite a high profile FAST (Face or Arm weakness, Speech difficulty, Time to call 999) campaign taking place at the same time as the study.
The risk of early recurrent stroke is reduced with rapid assessment and treatment of patients with TIA or minor strokes. The Royal College of Physicians' Guidelines suggests that high risk TIA patients should be seen within 24 hours of the onset of symptoms. Those at lower risk should be seen by a doctor within a week.
Professor Andrew Wilson of the University of Leicester led a team of researchers who interviewed 278 newly diagnosed TIA or minor stroke patients from a TIA rapid response clinic. They had all received their diagnosis between 1 December 2008 and 30 April 2010. Of the total group, 222 patients were diagnosed with TIA and 56 with stroke. The interview included questions about the onset of symptoms, when they sought help, their first consultation with a health care professional, attendance at the TIA clinic, and any additional contact with health care professionals before clinic attendance.
The team assessed 133 TIA patients as high-risk, with only 11 (8 percent) attending the TIA clinic within 24 hours. The low risk patients had a better percentage, with 47 (53 percent) of the 89 low-risk TIA patients seeking care at the clinic within the recommended 7 days.
Professor Wilson said, "Factors contributing to delay include incorrect interpretation of symptoms and failure to contact the emergency services, which demonstrates an on-going need for patient education. Despite the FAST campaign, which was taking place at the time of the study, only 60 percent of the patients we interviewed reported a FAST symptom, which is actually fewer than in some other studies."
The research team also discovered that service factors contributed to a delay in referral to the TIA clinic. The majority of patients who sought an out-of-hours General Practitioner (GP), and all who consulted an optometrist, had further consultation before attending the clinic. Optometrists often see patients who experience peripheral blindness as a stroke symptom. This additional consultation usually took place with a GP.
Wilson's team suggests that services could be streamlined to encourage clinic referral, as well as continued education for patients themselves. "Patients are encourage [sic] to respond urgently to symptoms, but when they do so, a significant number are then referred back to their GP. Our findings suggest that referral pathways from emergency departments and acute medical units could be improved."