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Long-term unmet needs and associated factors in stroke or TIA survivors: An observational study

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Olaiya, MT, Cadilhac, DA, Kim, J, Nelson, MR ORCID: 0000-0001-9941-7161, Srikanth, VK, Andrew, NE, Bladin, CF, Gerraty, RP, Fitzgerald, SM, Phan, T, Frayne, J and Thrift, AG 2017 , 'Long-term unmet needs and associated factors in stroke or TIA survivors: An observational study' , Neurology, vol. 89, no. 1 , pp. 68-75 , doi: 10.1212/WNL.0000000000004063.

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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.

Item Type: Article
Authors/Creators:Olaiya, MT and Cadilhac, DA and Kim, J and Nelson, MR and Srikanth, VK and Andrew, NE and Bladin, CF and Gerraty, RP and Fitzgerald, SM and Phan, T and Frayne, J and Thrift, AG
Journal or Publication Title: Neurology
Publisher: Lippincott Williams & Wilkins
ISSN: 0028-3878
DOI / ID Number: 10.1212/WNL.0000000000004063
Copyright Information:

© 2017 American Academy of Neurology

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