Journal
NEUROLOGY
Volume 89, Issue 1, Pages 68-75Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0000000000004063
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Funding
- National Health and Medical Research Council (NHMRC) of Australia [586605]
- NHMRC Senior Research Fellowships [1042600, 438700]
- NHMRC/National Heart Foundation Career Development Fellowships [1063761, 1061457]
- Monash Graduate Scholarship
- Monash International Postgraduate Research Scholarship [24909602]
- Stroke Foundation Postgraduate Scholarship [PP 10M 5505]
- Monash Partners Academic Health Science Centre
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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 1.161.82) 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.
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