Low awareness of transient ischemic attacks and risk factors of stroke in a Swiss urban community

Nedeltchev, Krassen; Fischer, Urs; Arnold, Marcel; Kappeler, Liliane; Mattle, Heinrich

doi:10.1007/s00415-006-0313-x

Cited by 48 publications

(64 citation statements)

References 23 publications

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“…However, less than one third of the general public can come up with more than two symptoms or risk factors and even fewer are considered to have an adequate knowledge of stroke or TIA. Similar results have been reported throughout the United States and across Europe and Asia (Kothari et al 1997, Pancioli et al 1998, Yoon et al 2001, Reeves et al 2002, Greenlund et al 2003, Parahoo et al 2003, Centers for Disease Control and Prevention 2004, Ferris et al 2005, Müller-Nordhorn et al 2006, Nedeltchev et al 2007, Evci et al 2007, Mikulík et al 2008. Women have been found to have a better overall symptom awareness and knowledge of risk factors than men (Ferris et al 2005).…”

Section: Knowledge Of Stroke Among the Publicsupporting

confidence: 75%

Stroke and the emergency medical services – enhancing performance within the chain of survival

Puolakka

2017

Acta Anaesthesiol Scand

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Section: Knowledge Of Stroke Among the Publicsupporting

confidence: 75%

Stroke and the emergency medical services – enhancing performance within the chain of survival

Puolakka

2017

Acta Anaesthesiol Scand

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“…15 Although previous studies have suggested that women, 6,8,10,12,13 and either young 10,13,16 or middle aged 12,14 patients have better knowledge and awareness of TIA and stroke the present study showed no sex or age-related differences in the responses obtained. Other reports have also highlighted that awareness of cerebrovascular disease is better in those with higher levels of education 6,8,[10][11][12]14,16,17 and higher income. 8,16,17 In this study 65% of respondents were socioeconomic class I and II and would be expected to be more knowledgeable suggesting that for the wider population appropriate responses to TIA are even less likely.…”

Section: Discussioncontrasting

confidence: 63%

“…Although the study cohort appeared uninformed about cerebrovascular disease, this data would seem to mirror those of the Swiss study in which 87.2% of people did not recall having heard the term 'transient ischaemic attack' and only 2.8% regarded TIA as a potentially harmful event, 6 even though their subsequent responses were more likely to be appropriate. In contrast, this lack of public awareness that TIA is a medical emergency was also evident in another recent study where only 44.4% of patients sought medical attention following a TIA.…”

Section: Discussionmentioning

confidence: 74%

“…This contrasts with a recent Swiss study which reported that 8% of the public would take no action following a TIA symptom. 6 From the publics' perspective dysphasia was the symptom for which they were most likely to seek medical attention, particularly if combined with a temporary motor deficit. For isolated motor symptoms, however, only 49% would seek medical attention.…”

Section: Discussionmentioning

confidence: 99%

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Can the UK guidelines for stroke be effective? Attitudes to the symptoms of a transient ischaemic attack among the general public and doctors

2008

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-This questionnaire-based study assessed the attitudes of the general public to the symptoms of a transient ischaemic attack (TIA) and determined the current level of knowledge about the management of TIA among doctors. The public chose to wait for symptom recurrence before seeking medical advice for amaurosis (41%) and upper limb (UL) monoparesis (51%), sensory loss (68%), or paraesthesia (95%). However, medical advice would be sought most often for slurred speech alone (89%) or combined with UL monoparesis (99%). Most physicians confirmed that these symptoms could represent a 'carotid TIA' but many considered diverse symptoms as relevant. While most general practitioners would prescribe anti-platelet therapy, 22-40% would not refer first-time TIA patients, depending upon the presenting symptom. In conclusion, the general public does not recognise the importance of TIA symptoms and the need for rapid assessment. This is compounded by deficiencies in the medical management of TIA. Stroke guidelines will remain ineffective without public awareness campaigns and physician education. KEY WORDS: health campaign, medical management, public awareness, stroke prevention, transient ischaemic attack IntroductionStroke is the third most common cause of mortality in the UK and the single largest cause of long-term disability. Up to 23% of ischaemic strokes are preceded by a transient ischaemic attack (TIA) 1 and the initial risk is as high as 5% in the first 48 hours. 2 In patients with a significant carotid stenosis a TIA represents an important opportunity for intervention and stroke prevention.The National clinical guidelines for stroke were developed to allow effective, early management of TIA, 3 and state that TIA should be assessed and investigated in a specialist clinic within seven days of the event and that carotid endarterectomy should be performed within two weeks when a significant carotid artery stenosis is confirmed. If surgery is delayed beyond 12 weeks it attracts little or no benefit, 4 while early management reduces stroke risk by as much as 80%. 5 Despite the evidence for early management of TIA, this rarely occurs due to delays in patient presentation and medical management. The aim of this study was to assess the attitudes of the general public to potential symptoms of TIA and to determine the current level of knowledge about its management among NHS doctors. Subjects and methods General publicAn orally administered questionnaire was used to assess the responses of 200 members of the public to symptoms of monocular visual loss, upper limb (UL) weakness, UL sensory loss, UL 'pins and needles' and speech disturbance with or without UL weakness. Twelve members of the public (6%) declined to respond to the questionnaire. Subjects were presented with the following three possible options for each symptom:A: Wait to see if it happens again before seeking medical advice B: Go to your general practitioner (GP) as soon as possible C: Go to the accident and emergency (A&E) department the same day. Subjec...

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“…Authors from Switzerland and the US demonstrated only 8.3% 13 and 8.6% 14 of the public sampled understood the symptoms of TIA. In addition, only 2.8% of the public appreciated the need for urgent medical attention following TIA.…”

Section: Discussionmentioning

confidence: 98%

The National Stroke Strategy – Is it Achievable?

Reid

Finney

Hedges

2009

annals

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INTRODUCTION Timing of intervention in symptomatic carotid disease is critical. The UK Department of Health's National Stroke Strategy published in December 2007 recommends urgent carotid intervention within 48 h, in appropriate patients, who have suffered a transient ischaemic attack (TIA), amaurosis fugax or minor stroke. Despite the running of a rapid-access clinic for patients with symptoms of TIA, the time from symptom to surgery is rarely less than 2 weeks. To date, there has been little published research on the UK public response to the symptoms of TIA, and no study at all of the response of primary care to such patients. The aim of this study was to ascertain both these responses to see whether a 48-h target is achievable. PATIENTS AND METHODS A total of 402 men attending our aortic aneurysm screening sessions were asked to complete a questionnaire requesting their most likely response to an episode of amaurosis fugax or TIA. All 45 GP practices in the hospital catchment area were asked how they would respond to patients requesting to be seen with the symptoms used in the questionnaire. RESULTS Nearly one in six patients would ignore the symptom unless it recurred, approximately half would request a GP appointment and a third would see an optician if they had amaurosis fugax. The mean waiting time to see a GP was 2 days for a routine appointment and within 24 h for an emergency appointment. CONCLUSIONS It is clear that a significant number of people would ignore the first symptom of carotid ischaemia; for those with amaurosis fugax, nearly a third would initially seek help from their optician. Those given a routine GP appointment would have to wait a minimum of 2 days. If the Department of Health is serious about reducing the incidence of stroke and introducing a target of 48 h from symptom to treatment, then there needs to be a wide-spread public and healthcare education programme, in particular alerting opticians and GP receptionists that these symptoms constitute a medical emergency.

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Low awareness of transient ischemic attacks and risk factors of stroke in a Swiss urban community

Cited by 48 publications

References 23 publications

Stroke and the emergency medical services – enhancing performance within the chain of survival

Stroke and the emergency medical services – enhancing performance within the chain of survival

Can the UK guidelines for stroke be effective? Attitudes to the symptoms of a transient ischaemic attack among the general public and doctors

The National Stroke Strategy – Is it Achievable?

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