PT  - JOURNAL ARTICLE
AU  - Olaiya, Muideen T.
AU  - Cadilhac, Dominique A.
AU  - Kim, Joosup
AU  - Nelson, Mark R.
AU  - Srikanth, Velandai K.
AU  - Andrew, Nadine E.
AU  - Bladin, Christopher F.
AU  - Gerraty, Richard P.
AU  - Fitzgerald, Sharyn M.
AU  - Phan, Thanh
AU  - Frayne, Judith
AU  - Thrift, Amanda G.
ED  - ,
TI  - Long-term unmet needs and associated factors in stroke or TIA survivors
AID  - 10.1212/WNL.0000000000004063
DP  - 2017 Jul 04
TA  - Neurology
PG  - 68--75
VI  - 89
IP  - 1
4099  - http://n.neurology.org/content/89/1/68.short
4100  - http://n.neurology.org/content/89/1/68.full
SO  - Neurology2017 Jul 04; 89
AB  - Objective: To extensively investigate long-term unmet needs in survivors of stroke or TIA and to identify factors associated with these unmet needs.Methods: Community-dwelling adults were invited to participate in a survey ≥2 years after discharge for stroke/TIA. Unmet needs were assessed across 5 domains: activities and participation, environmental factors, body functions, post–acute care, and secondary prevention. Factors associated with unmet needs were determined with multivariable negative binomial regression.Results: Of 485 participants invited to complete the survey, 391 (81%) responded (median age 73 years, 67% male). Most responders (87%) reported unmet needs in ≥1 of the measured domains, particularly in secondary prevention (71%). Factors associated with fewer unmet needs included older age (incident rate ratio [IRR] 0.62, 95% confidence interval [CI] 0.50–0.77), greater functional ability (IRR 0.33, 95% CI 0.17–0.67), and reporting that the general practitioner was the most important in care (IRR 0.69, 95% CI 0.57–0.84). Being depressed (IRR 1.61, 95% CI 1.23–2.10) and receiving community services after stroke (IRR 1.45, 95% CI 1.16–1.82) were associated with more unmet needs.Conclusions: Survivors of stroke/TIA reported considerable unmet needs ≥2 years after discharge, particularly in secondary prevention. The factors associated with unmet needs could help guide policy decisions, particularly for tailoring care and support services provided after discharge.CI=confidence interval; GP=general practitioner; IRR=incident rate ratio; STANDFIRM=Shared Team Approach Between Nurses and Doctors for Improved Risk Factor Management