Muideen T Olaiya1, Dominique A Cadilhac1, Joosup Kim1, Mark R Nelson1, Velandai K Srikanth1, Nadine E Andrew1, Christopher F Bladin1, Richard P Gerraty1, Sharyn M Fitzgerald1, Thanh Phan1, Judith Frayne1, Amanda G Thrift2. 1. From Stroke and Ageing Research (M.T.O., D.A.C., J.K., V.K.S., N.E.A., T.P., A.G.T.), Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton; Stroke Division (D.A.C., J.K., N.E.A.), Florey Institute of Neuroscience and Mental Health, Heidelberg; Menzies Institute for Medical Research (M.R.N., V.K.S.), Hobart; Department of Epidemiology and Preventive Medicine (M.R.N., S.M.F.), Monash University, Melbourne; School of Medicine (M.R.N.), University of Tasmania, Hobart; Department of Neurosciences (C.F.B.), Box Hill Hospital; Department of Medicine (R.P.G.), Epworth Healthcare, Monash University, Richmond; and Department of Neurology (J.F.), Alfred Hospital, Melbourne, Australia. 2. From Stroke and Ageing Research (M.T.O., D.A.C., J.K., V.K.S., N.E.A., T.P., A.G.T.), Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton; Stroke Division (D.A.C., J.K., N.E.A.), Florey Institute of Neuroscience and Mental Health, Heidelberg; Menzies Institute for Medical Research (M.R.N., V.K.S.), Hobart; Department of Epidemiology and Preventive Medicine (M.R.N., S.M.F.), Monash University, Melbourne; School of Medicine (M.R.N.), University of Tasmania, Hobart; Department of Neurosciences (C.F.B.), Box Hill Hospital; Department of Medicine (R.P.G.), Epworth Healthcare, Monash University, Richmond; and Department of Neurology (J.F.), Alfred Hospital, Melbourne, Australia. amanda.thrift@monash.edu.
Abstract
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.
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.
Authors: James Jamison; Luis Ayerbe; Gian Luca Di Tanna; Stephen Sutton; Jonathan Mant; Anna De Simoni Journal: BMJ Open Date: 2018-03-11 Impact factor: 2.692
Authors: Roderick Wondergem; Martijn F Pisters; Martijn W Heijmans; Eveline J M Wouters; Rob A de Bie; Cindy Veenhof; Johanna M A Visser-Meily Journal: PLoS One Date: 2020-03-26 Impact factor: 3.240