Follow-Up in Primary Care After Ischemic Stroke - Insights From the Nor-COAST Study

There is limited information on follow-up routines for adequate poststroke care after discharge from hospital.

This study aimed to assess the likelihood of general practitioner (GP) follow-up within 18 months after an ischemic stroke and to identify clinical factors influencing follow-up frequency.

Home-dwelling patients admitted to St. Olavs University Hospital with ischemic stroke between 2015 and 2017 were included. Follow-up was assessed by linkage to administrative health data, tracking GP visits over the 18-month period post discharge.

In total, 278 of the 302 patients included (92%) had at least one consultation, with a mean time to first consultation of 64 days (SD 96). Of these 278 patients, the cumulative probability of a consultation within 30, 90, 365, and 540 days was 56%, 81%, 96%, and 100%, respectively. The mean number of consultations during the 18-month follow-up was 6.2 (SD 6.7). Factors associated with a lower probability of consultation within the first 90 days included use of home care services (HR 0.56, 95% CI 0.41-0.77), disability (HR 0.70, 95% CI 0.61-0.79), frailty (HR 0.82, 95% CI 0.72-0.94), and cognitive impairment (HR 0.85, 95% CI 0.75-0.97). Additionally, older age (coefficient -0.09 per year, 95% CI -0.16 to -0.02), use of home care services (coefficient -2.34, 95% CI -4.52 to -0.15), and cognitive impairment (coefficient -0.77, 95% CI -1.46 to -0.09) were associated with fewer consultations.

Most patients had at least one GP consultation within 18 months poststroke. However, vulnerable patients with advanced age, frailty, disability, and cognitive impairment may be at risk of suboptimal follow-up after ischemic stroke.