RT Journal Article
SR Electronic
T1 Long-term unmet needs and associated factors in stroke or TIA survivors
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 68
OP 75
DO 10.1212/WNL.0000000000004063
VO 89
IS 1
A1 Olaiya, Muideen T.
A1 Cadilhac, Dominique A.
A1 Kim, Joosup
A1 Nelson, Mark R.
A1 Srikanth, Velandai K.
A1 Andrew, Nadine E.
A1 Bladin, Christopher F.
A1 Gerraty, Richard P.
A1 Fitzgerald, Sharyn M.
A1 Phan, Thanh
A1 Frayne, Judith
A1 Thrift, Amanda G.
A1 ,
YR 2017
UL http://n.neurology.org/content/89/1/68.abstract
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