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Title: Long-term unmet needs and associated factors in stroke or TIA survivors: An observational study.
Epworth Authors: Gerraty, Richard
Other Authors: Olaiya, M. T.
Cadilhac, Dominique
Kim, J.
Nelson, M. R.
Srikanth, Velandai
Andrew, Nadine
Bladin, Christopher
Fitzgerald, Sharyn
Phan, T. G.
Frayne, Judith
Thrift, Amanda
Keywords: TIA
Transient Ischemic Attack
Long-term Unmet Needs
Environmental Factors
Body Functions
Post-Acute Care
Secondary Prevention
Rehabilitation, Mental Health and Chronic Pain Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: May-2017
Publisher: American Academy of Neurology
Citation: Neurology. 2017 May 31.
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.
DOI: 10.1212/WNL.0000000000004063
PubMed URL:
ISSN: 0028-3878
Journal Title: Neurology
Type: Journal Article
Affiliated Organisations: Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton.
Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Menzies Institute for Medical Research, Hobart, Tasmania.
School of Medicine, University of Tasmania, Hobart
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne
Department of Neurosciences, Box Hill Hospital, Victoria, Australia
Department of Neurology, Alfred Hospital, Melbourne, Australia
Type of Clinical Study or Trial: Observational Study
Appears in Collections:Mental Health

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