Utility of a primary care based transient ischaemic attack electronic decision support tool: a prospective sequential...

Area of Science:

• Neurology
• Health Informatics
• Public Health

Background:

• Stroke is a leading cause of global mortality and disability.
• Transient ischaemic attacks (TIAs) are critical warning signs for impending strokes.
• Timely intervention post-TIA significantly reduces stroke risk and healthcare costs.

Purpose of the Study:

• To evaluate the impact of a primary care-based TIA/Stroke electronic decision support (EDS) tool.
• To assess the tool's effectiveness in improving access to specialist care.
• To determine if the EDS tool reduces management delays for TIA and stroke patients.

Main Methods:

• Prospective before-and-after study comparing 2009 (pre-EDS) and 2011 (post-EDS) data.
• Inclusion of all patients presenting with TIA to secondary services.
• Assessment of TIA Guideline adherence and patient safety outcomes.

Main Results:

• Median delay to specialist assessment decreased from 10 days to 3 days post-EDS implementation (p=0.001).
• Optimal medical therapy within 24 hours increased from 43% to 57% (p=0.04).
• Carotid and CT imaging were obtained significantly faster, with no adverse events reported.

Conclusions:

• Primary care-based electronic decision support for TIA/Stroke is associated with reduced management delays.
• The EDS tool facilitates faster access to specialist assessment and treatment.
• Implementation of the EDS tool improved care processes without compromising patient safety.