ArticleBMJ (Clinical research ed.)2008
Influence of general practice opening hours on delay in seeking medical attention after transient ischaemic attack (TIA) and minor stroke: prospective population based study.
Article in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Patient delay in TIA: a systematic review.Journal of neurology · 2019Pooled it
- Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials.Lancet (London, England) · 2016Pooled it
- Response to symptoms of stroke in the UK: a systematic review.BMC health services research · 2010Pooled it
- Efficacy and safety of a TIA/stroke electronic support tool (FASTEST) trial: study protocol.Implementation science : IS · 2012Trial
- Trial
- The weekend effect in stroke mortality: evidence from Austrian acute care hospitals.International journal of health economics and management · 2022Article
- Determinants of time-to-disposition in patients who underwent CT for pulmonary embolism: a retrospective study.BMC emergency medicine · 2021Observational
- Accuracy of telephone triage in patients suspected of transient ischaemic attack or stroke: a cross-sectional study.BMC family practice · 2020Article
- Risk Factors Influencing Seeking Emergency Medical Service in Urban and Rural China Among Participants With a Previous Transient Ischemic Attack.Frontiers in neurology · 2020Article
- Serum biomarkers in patients suspected of transient ischaemic attack in primary care: a diagnostic accuracy study.BMJ open · 2019Observational
- The weekend effect revisited: evidence from the Upper Austrian stroke registry.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Article
- Can people apply 'FAST' when it really matters? A qualitative study guided by the common sense self-regulation model.BMC public health · 2019Article
- ED Referral Dramatically Reduces Delays of Initial Evaluation in a French TIA Clinic.Frontiers in neurology · 2018Article
- When has service provision for transient ischaemic attack improved enough? A discrete event simulation economic modelling study.BMJ open · 2017Article
- Who breaches the four-hour emergency department wait time target? A retrospective analysis of 374,000 emergency department attendances between 2008 and 2013 at a type 1 emergency department in England.BMC emergency medicine · 2017Article
- Online Reviews as Health Data: Examining the Association Between Availability of Health Care Services and Patient Star Ratings Exemplified by the Yelp Academic Dataset.JMIR public health and surveillance · 2017Article
- Patients' anticipated actions following transient ischaemic attack symptoms: a qualitative vignette-based study.BMC family practice · 2017Article
- Article
- Patients' responses to transient ischaemic attack symptoms: a cross-sectional questionnaire study in Australian general practices.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Article
- Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.PloS one · 2015Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo assess the influence of general practice opening hours on healthcare seeking behaviour after transient ischaemic attack (TIA) and minor stroke and feasibility of clinical assessment within 24 hours of symptom onset.
designPopulation based prospective incidence study (Oxford vascular study).
settingNine general practices in Oxfordshire.
participants91 000 patients followed from 1 April 2002 to 31 March 2006.
main outcome measuresEvents that occurred overnight and at weekends (out of hours) and events that occurred during surgery hours.
resultsAmong 359 patients with TIA and 434 with minor stroke, the median (interquartile range) time to call a general practitioner after an event during surgery hours was 4.0 (1.0-45.5) hours, and 68% of patients with events during surgery hours called within 24 hours of onset of symptoms. Median (interquartile range) time to call a general practitioner after events out of hours was 24.8 (9.0-54.5) hours for patients who waited to contact their registered practice compared with 1.0 (0.3-2.6) hour in those who used an emergency general practitioner service (P<0.001). In patients with events out of hours who waited to see their own general practitioner, seeking attention within 24 hours was considerably less likely for events at weekends than weekdays (odds ratio 0.10, 95% confidence interval 0.05 to 0.21): 70% with events Monday to Friday, 33% on Sundays, and none on Saturdays. Thirteen patients who had events out of hours and did not seek emergency care had a recurrent stroke before they sought medical attention. A primary care centre open 8 am-8 pm seven days a week would have offered cover to 73 patients who waited until surgery hours to call their general practitioner, reducing median delay from 50.1 hours to 4.0 hours in that group and increasing those calling within 24 hours from 34% to 68%.
conclusionsGeneral practitioners' opening hours influence patients' healthcare seeking behaviour after TIA and minor stroke. Current opening hours can increase delay in assessment. Improved access to primary care and public education about the need for emergency care are required if the relevant targets in the national stroke strategy are to be met.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.