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Title: Long-term unmet needs and associated factors in stroke or TIA survivors: An observational study.
Austin Authors: Olaiya, Muideen T;Cadilhac, Dominique A;Kim, Joosup;Nelson, Mark R;Srikanth, Velandai K;Andrew, Nadine E;Bladin, Christopher F;Gerraty, Richard P;Fitzgerald, Sharyn M;Phan, Thanh;Frayne, Judith;Thrift, Amanda G
Affiliation: Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton
Department of Neurology, Alfred Hospital, Melbourne, Australia
Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Menzies Institute for Medical Research, Hobart, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
School of Medicine, University of Tasmania, Hobart, Australia
Department of Neurosciences, Box Hill Hospital, Australia
Department of Medicine, Epworth Healthcare, Monash University, Richmond, Australia
Issue Date: 4-Jul-2017
Date: 2017-05-31
Publication information: Neurology 2017; 89(1): 68-75
Abstract: To extensively investigate long-term unmet needs in survivors of stroke or TIA and to identify factors associated with these unmet needs. 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. 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. 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.
DOI: 10.1212/WNL.0000000000004063
ORCID: 0000-0001-8162-682X
Journal: Neurology
PubMed URL: 28566545
Type: Journal Article
Appears in Collections:Journal articles

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