title: Is health-related quality of life between 90 and 180 days following stroke associated with long-term unmet needs?
abstract: Understanding the relationship between health-related quality of life (HRQoL) and long-term unmet needs is important for guiding services to optimise life following stroke. We investigated whether HRQoL between 90 and 180 days following stroke was associated with long-term unmet needs.
  
  
  
  Data from Australian Stroke Clinical Registry (AuSCR) registrants who participated in the Australian Stroke Survivor Needs Survey were used. Outcome data, including the EQ-5D, are routinely collected in AuSCR between 90 and 180 days post-stroke. Unmet needs were assessed at a median of 2 years and categorised into: health; everyday living; work/leisure; and support domains. Multivariable regression was used to determine associations between the EQ-5D dimensions and the likelihood of experiencing unmet needs and the visual analogue scale (VAS) (rating 0-100) and number of reported unmet needs.
  
  
  
  In total, 173 AuSCR registrants completed the Needs Survey (median age 69 years, 67 % male; 77 % ischaemic stroke). VAS scores were negatively associated with the number of reported long-term unmet needs [irr 0.98, (95 % CI 0.97, 0 99) p < 0.001]. Having EQ-5D activity limitations was associated with unmet living needs (aOR 4.5, 95 % CI 1.1, 18.8). Requiring living supports at 90-180 days was associated with unmet health needs (aOR 4.9, 95 % CI 1.5, 16.1). Those with pain at 90-180 days were less likely to report unmet health (aOR 0.09, 95 % CI 0.02, 0.4) and support needs (aOR 0.2, 95 % CI 0.06, 0.6).
  
  
  
  Routinely collected HRQoL data can identify survivors at risk of experiencing long-term unmet needs. This information is important for targeting service delivery to optimise outcomes following stroke.
authors: Translational Public Health Division, Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia. nadine.andrew@monash.edu.
authors: N E
authors: NE
authors: Andrew
authors: Translational Public Health Division, Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.|Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia.
authors: M F
authors: MF
authors: Kilkenny
authors: Faculty of Health Sciences, La Trobe University, Melbourne, VIC, Australia.|Occupational Therapy Department, Alfred Health, Melbourne, VIC, Australia.
authors: N A
authors: NA
authors: Lannin
authors: Translational Public Health Division, Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.|Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia.
authors: D A
authors: DA
authors: Cadilhac
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018434:Sickness Impact Profile; D020521:Stroke / Q000401:mortality / Q000503:physiopathology / Q000523:psychology*; D013997:Time Factors
keywords: EQ-5D; Health-related quality of life; International Classification of Function; Long-term outcomes; Stroke; Unmet needs