No Cover Image

Journal article 242 views

Referral pathways for patients with TIA avoiding hospital admission: a scoping review

Bridie Evans Orcid Logo, Khalid Ali, Jenna Bulger, Gary A Ford, Matthew Jones, Chris Moore, Alison Porter Orcid Logo, Alan David Pryce, Tom Quinn, Anne Seagrove, Helen Snooks Orcid Logo, Shirley Whitman, Nigel Rees

BMJ Open, Volume: 7, Issue: 2, Start page: e013443

Swansea University Authors: Bridie Evans Orcid Logo, Matthew Jones, Alison Porter Orcid Logo, Anne Seagrove, Helen Snooks Orcid Logo

Full text not available from this repository: check for access using links below.

Abstract

AbstractObjective To identify the features and effects of a pathway for emergency assessment and referral of patients with suspected transient ischaemic attack (TIA) in order to avoid admission to hospital.Design Scoping review.Data sources PubMed, CINAHL Web of Science, Scopus.Study selection Repor...

Full description

Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: BMJ 2017
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa63477
Tags: Add Tag
No Tags, Be the first to tag this record!
Abstract: AbstractObjective To identify the features and effects of a pathway for emergency assessment and referral of patients with suspected transient ischaemic attack (TIA) in order to avoid admission to hospital.Design Scoping review.Data sources PubMed, CINAHL Web of Science, Scopus.Study selection Reports of primary research on referral of patients with suspected TIA directly to specialist outpatient services.Data extraction We screened studies for eligibility and extracted data from relevant studies. Data were analysed to describe setting, assessment and referral processes, treatment, implementation and outcomes.Results 8 international studies were identified, mostly cohort designs. 4 pathways were used by family doctors and 3 pathways by emergency department physicians. No pathways used by paramedics were found. Referrals were made to specialist clinic either directly or via a 24-hour helpline. Practitioners identified TIA symptoms and risk of further events using a checklist including the ABCD2 tool or clinical assessment. Antiplatelet medication was often given, usually aspirin unless contraindicated. Some patients underwent tests before referral and discharge. 5 studies reported reduced incident of stroke at 90 days, from 6–10% predicted rate to 1.3–2.1% actual rate. Between 44% and 83% of suspected TIA cases in these studies were referred through the pathways.Conclusions Research literature has focused on assessment and referral by family doctors and ED physicians to reduce hospitalisation of patients with TIA. No pathways for paramedical use were reported. We will use results of this scoping review to inform development of a paramedical referral pathway to be tested in a feasibility trial.Trial registration number ISRCTN85516498. Stage: pre-results.
College: Faculty of Medicine, Health and Life Sciences
Issue: 2
Start Page: e013443