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The role of the GP in managing suspected transient ischaemic attack: a qualitative study

BACKGROUND: National guidelines recommend patients with suspected transient ischaemic attack (TIA) should be seen by a specialist within 24 h. However, people with suspected TIA often present to non-specialised services, particularly primary care. Therefore, general practitioners (GPs) have a crucia...

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Autores principales: Edwards, Duncan, Turner, Grace M., Virdee, Satnam K., Mant, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530060/
https://www.ncbi.nlm.nih.gov/pubmed/31113364
http://dx.doi.org/10.1186/s12875-019-0963-2
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author Edwards, Duncan
Turner, Grace M.
Virdee, Satnam K.
Mant, Jonathan
author_facet Edwards, Duncan
Turner, Grace M.
Virdee, Satnam K.
Mant, Jonathan
author_sort Edwards, Duncan
collection PubMed
description BACKGROUND: National guidelines recommend patients with suspected transient ischaemic attack (TIA) should be seen by a specialist within 24 h. However, people with suspected TIA often present to non-specialised services, particularly primary care. Therefore, general practitioners (GPs) have a crucial role in recognition and urgent referral of people with suspected TIA. This study aims to explore the role of GPs in the initial management of suspected TIA in the United Kingdom (UK). METHODS: One-to-one, semi-structured interviews with GPs, TIA clinic staff and patients with suspected TIA from two sites in the UK: Cambridge and Birmingham. Thematic analysis was undertaken to explore views on the role of the GP in managing suspected TIA. Thirty semi-structured interviews were conducted with stroke patients (n = 12), GPs (n = 9) and TIA clinic hospital staff (n = 9) from two hospitals and nine GP practices in surrounding areas. RESULTS: Three overarching themes were identified: (1) multiple management pathways for suspected TIA; (2) uncertainty regarding suspected TIA as an emergency or routine situation; and (3) influences on the urgency of GP management. CONCLUSIONS: Guidelines on the primary care management of TIA describe only a small proportion of the factors which influence GP management and referral of suspected TIA. Efforts to improve treatment, appropriate referral and patient experience should use a real rather than idealised model of the GP role in managing suspected TIA. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12875-019-0963-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-65300602019-05-28 The role of the GP in managing suspected transient ischaemic attack: a qualitative study Edwards, Duncan Turner, Grace M. Virdee, Satnam K. Mant, Jonathan BMC Fam Pract Research Article BACKGROUND: National guidelines recommend patients with suspected transient ischaemic attack (TIA) should be seen by a specialist within 24 h. However, people with suspected TIA often present to non-specialised services, particularly primary care. Therefore, general practitioners (GPs) have a crucial role in recognition and urgent referral of people with suspected TIA. This study aims to explore the role of GPs in the initial management of suspected TIA in the United Kingdom (UK). METHODS: One-to-one, semi-structured interviews with GPs, TIA clinic staff and patients with suspected TIA from two sites in the UK: Cambridge and Birmingham. Thematic analysis was undertaken to explore views on the role of the GP in managing suspected TIA. Thirty semi-structured interviews were conducted with stroke patients (n = 12), GPs (n = 9) and TIA clinic hospital staff (n = 9) from two hospitals and nine GP practices in surrounding areas. RESULTS: Three overarching themes were identified: (1) multiple management pathways for suspected TIA; (2) uncertainty regarding suspected TIA as an emergency or routine situation; and (3) influences on the urgency of GP management. CONCLUSIONS: Guidelines on the primary care management of TIA describe only a small proportion of the factors which influence GP management and referral of suspected TIA. Efforts to improve treatment, appropriate referral and patient experience should use a real rather than idealised model of the GP role in managing suspected TIA. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12875-019-0963-2) contains supplementary material, which is available to authorized users. BioMed Central 2019-05-21 /pmc/articles/PMC6530060/ /pubmed/31113364 http://dx.doi.org/10.1186/s12875-019-0963-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Edwards, Duncan
Turner, Grace M.
Virdee, Satnam K.
Mant, Jonathan
The role of the GP in managing suspected transient ischaemic attack: a qualitative study
title The role of the GP in managing suspected transient ischaemic attack: a qualitative study
title_full The role of the GP in managing suspected transient ischaemic attack: a qualitative study
title_fullStr The role of the GP in managing suspected transient ischaemic attack: a qualitative study
title_full_unstemmed The role of the GP in managing suspected transient ischaemic attack: a qualitative study
title_short The role of the GP in managing suspected transient ischaemic attack: a qualitative study
title_sort role of the gp in managing suspected transient ischaemic attack: a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530060/
https://www.ncbi.nlm.nih.gov/pubmed/31113364
http://dx.doi.org/10.1186/s12875-019-0963-2
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