Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study.
BACKGROUND
Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care.


METHODS
Postal survey of random sample of general practitioners undertaken (N = 204; 46% response). Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation.


RESULTS
Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care.


CONCLUSIONS
General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care.
Whitford
David L
DL
Department of Family & Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, PO Box 15503, Adliya, Kingdom of Bahrain. dwhitford@rcsi-mub.com
Hickey
Anne
A
Horgan
Frances
F
O'Sullivan
Bernadette
B
McGee
Hannah
H
O'Neill
Desmond
D
D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D007494:Ireland; D008134:Long-Term Care / Q000458:organization & administration; D020380:Needs Assessment; D010821:Physicians, Family / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration; D020521:Stroke / Q000517:prevention & control / Q000628:therapy*; D000071939:Stroke Rehabilitation