Transient Ischaemic Attack (TIA) Knowledge in General Practice: a cross-sectional study of Western Adelaide general practitioners

A self-administered questionnaire was mailed to all GPs (n？=？202) in the Adelaide Western General Practice Network. Response frequencies were calculated for all variables, and associations examined by univariate analysis.32 GPs responded. All respondents correctly identified early risk of stroke following a TIA. Difficulty accessing neurological expertise was identified as a barrier (40.6？%), as was a lack of GP knowledge (18.8？%). Areas for improvement included access to neurologists (36.7？%), relevant guidelines and education (43.3？%).Diagnosis of TIA is difficult and this study highlights the need for further education and practical guidelines for GPs. With this training, GPs could be better equipped to assess and manage TIAs effectively in the community in consultation with stroke physicians.The role of the general practitioner (GP) can be significant in the assessment and management of transient ischaemic attacks (TIAs). TIA patients may regard their symptoms with less urgency and present to primary care, and the diagnosis can be a difficult one. Increasing evidence supports early urgent assessment and management of TIAs to prevent subsequent stroke. An estimated 20？% of strokes are preceded by a TIA, with the risk of stroke following a TIA being between 10-20？% in the next 90？days [1], and half of these patients suffer a stroke within the first 48 hours [2]. A recent study of a 24-hour TIA clinic reported that 74？% of patients were discharged home after prompt assessment and treatment, potentially lowering costs [3]. Early assessment and initiation of treatment of TIAs has also been associated with an 80？% reduction of early subsequent stroke in another study by Rothwell et al [4]. However, the approach to care varies both nationally and internationally, with some advocating for admission and others suggesting ambulatory care.There are currently no formal pathways for TIA care in Adelaide and it is unclear how GPs manage patients who present with suspected TIA