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.

Original languageEnglish
Pages (from-to)68-75
Number of pages8
JournalNeurology
Volume89
Issue number1
DOIs
Publication statusPublished - 4 Jul 2017

Cite this

@article{684d433cec454c72bd3e9b4c467f928a,
title = "Long-term unmet needs and associated factors in stroke or TIA survivors",
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.",
author = "Olaiya, {Muideen T.} and Cadilhac, {Dominique A.} and Joosup Kim and Nelson, {Mark R.} and Velandai Srikanth and Andrew, {Nadine E.} and Bladin, {Christopher F.} and Gerraty, {Richard P.} and Fitzgerald, {Sharyn M.} and Thanh Phan and Judith Frayne and Thrift, {Amanda G.}",
year = "2017",
month = "7",
day = "4",
doi = "10.1212/WNL.0000000000004063",
language = "English",
volume = "89",
pages = "68--75",
journal = "Neurology",
issn = "0028-3878",
publisher = "AAN Enterprises",
number = "1",

}

TY - JOUR

T1 - Long-term unmet needs and associated factors in stroke or TIA survivors

AU - Olaiya, Muideen T.

AU - Cadilhac, Dominique A.

AU - Kim, Joosup

AU - Nelson, Mark R.

AU - Srikanth, Velandai

AU - Andrew, Nadine E.

AU - Bladin, Christopher F.

AU - Gerraty, Richard P.

AU - Fitzgerald, Sharyn M.

AU - Phan, Thanh

AU - Frayne, Judith

AU - Thrift, Amanda G.

PY - 2017/7/4

Y1 - 2017/7/4

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85021921773&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000004063

DO - 10.1212/WNL.0000000000004063

M3 - Article

VL - 89

SP - 68

EP - 75

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 1

ER -