Rural Versus Metropolitan Comparison of Processes of Care in the Community‐based Management of TIA and Minor Stroke in Australia (an Analysis from the INSIST Study)

Simple item page
aut.relation.journalAustralian Journal of Rural Healthen_NZ
aut.researcherFeigin, Valery
dc.contributor.authorGangadharan, Sen_NZ
dc.contributor.authorTomari, Sen_NZ
dc.contributor.authorLevi, CRen_NZ
dc.contributor.authorWeaver, Nen_NZ
dc.contributor.authorHolliday, Een_NZ
dc.contributor.authorBajorek, Ben_NZ
dc.contributor.authorLasserson, Den_NZ
dc.contributor.authorValderas, JMen_NZ
dc.contributor.authorDewey, HMen_NZ
dc.contributor.authorBarber, PAen_NZ
dc.contributor.authorSpratt, NJen_NZ
dc.contributor.authorCadilhac, DAen_NZ
dc.contributor.authorFeigin, VLen_NZ
dc.contributor.authorRothwell, PMen_NZ
dc.contributor.authorZareie, Hen_NZ
dc.contributor.authorGarcia‐Esperon, Cen_NZ
dc.contributor.authorDavey, Aen_NZ
dc.contributor.authorNajib, Nen_NZ
dc.contributor.authorSales, Men_NZ
dc.contributor.authorMagin, Pen_NZ
dc.date.accessioned2022-11-16T21:38:26Z
dc.date.available2022-11-16T21:38:26Z
dc.date.copyright2022en_NZ
dc.date.issued2022en_NZ
dc.description.abstractObjectives To compare processes of care and clinical outcomes of community-based management of TIAs and minor strokes (TIAMS) between rural and metropolitan Australia. Design Inception cohort study between 2012 and 2016 with 12-month follow-up after index event (sub-study of INSIST). Setting Hunter and Manning valley regions of New South Wales, within the referral territory of the John Hunter Hospital Acute Neurovascular Clinic (JHHANC). Participants Consecutive patients of 16 participating general practices, presenting with possible TIAMS to either primary or secondary care. Main Outcome Measures Processes of care (referrals, key management processes, time-based metrics) and clinical outcomes. Results Of 613 participants with possible TIAMS who completed the baseline interview, 298 were adjudicated as having TIAMS (119 from rural, 179 from metropolitan). Mean age was 72.3 years (SD, 10.7) and 127 (43%) were women. Rural participants were more likely to be managed solely by a general practitioner (GP) than metropolitan participants (34% v 20%) and less likely to be referred to a JHHANC specialist (13% v 38%) or have brain magnetic resonance imaging (MRI) [24% v 51%]. Those rural participants who were referred, also waited longer (both p < 0.001). Recurrent stroke, myocardial infarction and death at 12 months were not significantly different between rural and metropolitan participants. Conclusions Although TIAMS prognosis in rural settings where solely GP care is common is very good, the processes of care in such areas are inferior to metropolitan. This suggests there is further scope to support rural GPs to optimise care of TIAMS patients.
dc.identifier.citationAustralian Journal of Rural Health, DOI: https://doi.org/10.1111/ajr.12950
dc.identifier.doi10.1111/ajr.12950en_NZ
dc.identifier.issn1038-5282en_NZ
dc.identifier.issn1440-1584en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/15622
dc.languageenen_NZ
dc.publisherWileyen_NZ
dc.relation.urihttp://dx.doi.org/10.1111/ajr.12950en_NZ
dc.rights© 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectCommunity stroke care; General practitioner; Health patient-reported outcomes; Stroke-mimic
dc.titleRural Versus Metropolitan Comparison of Processes of Care in the Community‐based Management of TIA and Minor Stroke in Australia (an Analysis from the INSIST Study)en_NZ
dc.typeJournal Article
pubs.elements-id483229
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Faculty of Health & Environmental Sciences
pubs.organisational-data/AUT/Faculty of Health & Environmental Sciences/School of Clinical Sciences
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Rural versus metropolitan comparison of processes of care in the community-based management of TIA and minor stroke in Australia.pdf
Size:
946.66 KB
Format:
Adobe Portable Document Format
Description:
Journal article
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
AUT Grant of Licence for Tuwhera Jun 2021.pdf
Size:
360.95 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
School of Clinical Sciences