Open Access Research article

Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study

David L Whitford1*, Anne Hickey2, Frances Horgan3, Bernadette O'Sullivan2, Hannah McGee2 and Desmond O'Neill4

Author Affiliations

1 Department of Family & Community Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, PO Box 15503, Adliya, Kingdom of Bahrain

2 Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland

3 School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin 2, Ireland

4 Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland

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BMC Family Practice 2009, 10:27  doi:10.1186/1471-2296-10-27

Published: 29 April 2009

Abstract

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.

Conclusion

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.