Management of Transient Ischemic Attacks by the General Practitioner

Abstract

Since little is known about the management of patients with a transient ischemic attack (TIA) by the general practitioner (GP), we sent a questionnaire to 474 GPs in the area around the Academic Medical Center in Amsterdam. In this questionnaire, we inquired about characteristics of the last patient diagnosed with a TIA and about the management of this patient by the GP. After three mailings, we received answers from 308 GPs (66%) of which 287 were informative. The main interventions the GP performed were physical examination (91%) and prescription of aspirin (74%). In a minority of cases (47%), a neurologist was consulted who performed further investigations. Multivariate analysis showed that younger patients (odds ratio 2.5; 95% confidence limits 1.5–4.2) and those who were independent in activities of daily living (odds ratio 2.2; 95% confidence limits 1.1–4.3) were referred more often. Male patients were more likely to be referred than female patients, although this difference was not statistically significant. We conclude that a health benefit might be achieved by subjecting more TIA patients to ancillary investigations.