Abstract
BackgroundNational guidelines recommend patients with suspected transient ischaemic attack (TIA) should be seen by a specialist within 24 h. However, people with suspected TIA often present to non-specialised services, particularly primary care. Therefore, general practitioners (GPs) have a crucial role in recognition and urgent referral of people with suspected TIA. This study aims to explore the role of GPs in the initial management of suspected TIA in the United Kingdom (UK).MethodsOne-to-one, semi-structured interviews with GPs, TIA clinic staff and patients with suspected TIA from two sites in the UK: Cambridge and Birmingham. Thematic analysis was undertaken to explore views on the role of the GP in managing suspected TIA. Thirty semi-structured interviews were conducted with stroke patients (n = 12), GPs (n = 9) and TIA clinic hospital staff (n = 9) from two hospitals and nine GP practices in surrounding areas.ResultsThree overarching themes were identified: (1) multiple management pathways for suspected TIA; (2) uncertainty regarding suspected TIA as an emergency or routine situation; and (3) influences on the urgency of GP management.ConclusionsGuidelines on the primary care management of TIA describe only a small proportion of the factors which influence GP management and referral of suspected TIA. Efforts to improve treatment, appropriate referral and patient experience should use a real rather than idealised model of the GP role in managing suspected TIA.
Highlights
National guidelines recommend patients with suspected transient ischaemic attack (TIA) should be seen by a specialist within 24 h
This study aims to explore the role of general practitioners (GPs) in the initial management of suspected Transient ischaemic attack (TIA) in the United Kingdom (UK)
Thirty semi-structured interviews were conducted with stroke patients (n = 12), GPs (n = 9) and TIA clinic hospital staff (n = 9) from two hospitals (Cambridge and Birmingham) and nine GP practices in surrounding areas
Summary
National guidelines recommend patients with suspected transient ischaemic attack (TIA) should be seen by a specialist within 24 h. People with suspected TIA often present to non-specialised services, primary care. General practitioners (GPs) have a crucial role in recognition and urgent referral of people with suspected TIA. This study aims to explore the role of GPs in the initial management of suspected TIA in the United Kingdom (UK). Transient ischaemic attack (TIA) occurs when blood flow to the brain is temporarily disrupted; symptoms are similar to a full stroke but short lasting, such a weakness, speech and vison disturbance [1, 2]. Evidence-based guidelines recommend that patients with suspected TIA should be treated with aspirin immediately and assessed by a specialist physician in a neurovascular clinic or an acute stroke unit [5]. People with suspected TIA present to non-specialised services
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