No Cover Image

Journal article 1142 views 154 downloads

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

Matthew Jones, 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: Matthew Jones, Bridie Evans Orcid Logo, Matthew Jones, Chris Moore, Alison Porter Orcid Logo, Anne Seagrove, Helen Snooks Orcid Logo

  • 39030.pdf

    PDF | Version of Record

    This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license

    Download (1.12MB)

Check full text

DOI (Published version): 10.1136/bmjopen-2016-013443

Abstract

Objective: 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 o...

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/cronfa39030
first_indexed 2018-03-12T20:29:38Z
last_indexed 2023-01-11T14:15:00Z
id cronfa39030
recordtype SURis
fullrecord <?xml version="1.0"?><rfc1807><datestamp>2022-11-11T15:33:10.8931277</datestamp><bib-version>v2</bib-version><id>39030</id><entry>2018-03-12</entry><title>Referral pathways for patients with TIA avoiding hospital admission: a scoping review</title><swanseaauthors><author><sid>e3595273bb063f8694ce43326f4bd298</sid><firstname>Matthew</firstname><surname>Jones</surname><name>Matthew Jones</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>6098eddc58e31ac2f3e070cb839faa6a</sid><ORCID>0000-0003-0293-0888</ORCID><firstname>Bridie</firstname><surname>Evans</surname><name>Bridie Evans</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>d063b18627093a02f325955f76eeeb76</sid><firstname>Matthew</firstname><surname>Jones</surname><name>Matthew Jones</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>f1321a88018c30e9c494421f899ac0cd</sid><firstname>Chris</firstname><surname>Moore</surname><name>Chris Moore</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>fcc861ec479a79f7fb9befb13192238b</sid><ORCID>0000-0002-3408-7007</ORCID><firstname>Alison</firstname><surname>Porter</surname><name>Alison Porter</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>33ab56cb67d7b1ef58f0280af1744e0d</sid><ORCID/><firstname>Anne</firstname><surname>Seagrove</surname><name>Anne Seagrove</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>ab23c5e0111b88427a155a1f495861d9</sid><ORCID>0000-0003-0173-8843</ORCID><firstname>Helen</firstname><surname>Snooks</surname><name>Helen Snooks</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2018-03-12</date><deptcode>PSYS</deptcode><abstract>Objective: 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&#x2013;10% predicted rate to 1.3&#x2013;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.</abstract><type>Journal Article</type><journal>BMJ Open</journal><volume>7</volume><journalNumber>2</journalNumber><paginationStart>e013443</paginationStart><paginationEnd/><publisher>BMJ</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2044-6055</issnPrint><issnElectronic>2044-6055</issnElectronic><keywords/><publishedDay>14</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2017</publishedYear><publishedDate>2017-02-14</publishedDate><doi>10.1136/bmjopen-2016-013443</doi><url/><notes/><college>COLLEGE NANME</college><department>Psychology School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PSYS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders/><projectreference/><lastEdited>2022-11-11T15:33:10.8931277</lastEdited><Created>2018-03-12T16:59:20.3835786</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Matthew</firstname><surname>Jones</surname><order>1</order></author><author><firstname>Bridie</firstname><surname>Evans</surname><orcid>0000-0003-0293-0888</orcid><order>2</order></author><author><firstname>Khalid</firstname><surname>Ali</surname><order>3</order></author><author><firstname>Jenna</firstname><surname>Bulger</surname><order>4</order></author><author><firstname>Gary A</firstname><surname>Ford</surname><order>5</order></author><author><firstname>Matthew</firstname><surname>Jones</surname><order>6</order></author><author><firstname>Chris</firstname><surname>Moore</surname><order>7</order></author><author><firstname>Alison</firstname><surname>Porter</surname><orcid>0000-0002-3408-7007</orcid><order>8</order></author><author><firstname>Alan David</firstname><surname>Pryce</surname><order>9</order></author><author><firstname>Tom</firstname><surname>Quinn</surname><order>10</order></author><author><firstname>Anne</firstname><surname>Seagrove</surname><orcid/><order>11</order></author><author><firstname>Helen</firstname><surname>Snooks</surname><orcid>0000-0003-0173-8843</orcid><order>12</order></author><author><firstname>Shirley</firstname><surname>Whitman</surname><order>13</order></author><author><firstname>Nigel</firstname><surname>Rees</surname><order>14</order></author></authors><documents><document><filename>0039030-10042018103820.pdf</filename><originalFilename>39030.pdf</originalFilename><uploaded>2018-04-10T10:38:20.0800000</uploaded><type>Output</type><contentLength>1225984</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by-nc/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2022-11-11T15:33:10.8931277 v2 39030 2018-03-12 Referral pathways for patients with TIA avoiding hospital admission: a scoping review e3595273bb063f8694ce43326f4bd298 Matthew Jones Matthew Jones true false 6098eddc58e31ac2f3e070cb839faa6a 0000-0003-0293-0888 Bridie Evans Bridie Evans true false d063b18627093a02f325955f76eeeb76 Matthew Jones Matthew Jones true false f1321a88018c30e9c494421f899ac0cd Chris Moore Chris Moore true false fcc861ec479a79f7fb9befb13192238b 0000-0002-3408-7007 Alison Porter Alison Porter true false 33ab56cb67d7b1ef58f0280af1744e0d Anne Seagrove Anne Seagrove true false ab23c5e0111b88427a155a1f495861d9 0000-0003-0173-8843 Helen Snooks Helen Snooks true false 2018-03-12 PSYS Objective: 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. Journal Article BMJ Open 7 2 e013443 BMJ 2044-6055 2044-6055 14 2 2017 2017-02-14 10.1136/bmjopen-2016-013443 COLLEGE NANME Psychology School COLLEGE CODE PSYS Swansea University 2022-11-11T15:33:10.8931277 2018-03-12T16:59:20.3835786 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Matthew Jones 1 Bridie Evans 0000-0003-0293-0888 2 Khalid Ali 3 Jenna Bulger 4 Gary A Ford 5 Matthew Jones 6 Chris Moore 7 Alison Porter 0000-0002-3408-7007 8 Alan David Pryce 9 Tom Quinn 10 Anne Seagrove 11 Helen Snooks 0000-0003-0173-8843 12 Shirley Whitman 13 Nigel Rees 14 0039030-10042018103820.pdf 39030.pdf 2018-04-10T10:38:20.0800000 Output 1225984 application/pdf Version of Record true This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license true eng http://creativecommons.org/licenses/by-nc/4.0/
title Referral pathways for patients with TIA avoiding hospital admission: a scoping review
spellingShingle Referral pathways for patients with TIA avoiding hospital admission: a scoping review
Matthew Jones
Bridie Evans
Matthew Jones
Chris Moore
Alison Porter
Anne Seagrove
Helen Snooks
title_short Referral pathways for patients with TIA avoiding hospital admission: a scoping review
title_full Referral pathways for patients with TIA avoiding hospital admission: a scoping review
title_fullStr Referral pathways for patients with TIA avoiding hospital admission: a scoping review
title_full_unstemmed Referral pathways for patients with TIA avoiding hospital admission: a scoping review
title_sort Referral pathways for patients with TIA avoiding hospital admission: a scoping review
author_id_str_mv e3595273bb063f8694ce43326f4bd298
6098eddc58e31ac2f3e070cb839faa6a
d063b18627093a02f325955f76eeeb76
f1321a88018c30e9c494421f899ac0cd
fcc861ec479a79f7fb9befb13192238b
33ab56cb67d7b1ef58f0280af1744e0d
ab23c5e0111b88427a155a1f495861d9
author_id_fullname_str_mv e3595273bb063f8694ce43326f4bd298_***_Matthew Jones
6098eddc58e31ac2f3e070cb839faa6a_***_Bridie Evans
d063b18627093a02f325955f76eeeb76_***_Matthew Jones
f1321a88018c30e9c494421f899ac0cd_***_Chris Moore
fcc861ec479a79f7fb9befb13192238b_***_Alison Porter
33ab56cb67d7b1ef58f0280af1744e0d_***_Anne Seagrove
ab23c5e0111b88427a155a1f495861d9_***_Helen Snooks
author Matthew Jones
Bridie Evans
Matthew Jones
Chris Moore
Alison Porter
Anne Seagrove
Helen Snooks
author2 Matthew Jones
Bridie Evans
Khalid Ali
Jenna Bulger
Gary A Ford
Matthew Jones
Chris Moore
Alison Porter
Alan David Pryce
Tom Quinn
Anne Seagrove
Helen Snooks
Shirley Whitman
Nigel Rees
format Journal article
container_title BMJ Open
container_volume 7
container_issue 2
container_start_page e013443
publishDate 2017
institution Swansea University
issn 2044-6055
2044-6055
doi_str_mv 10.1136/bmjopen-2016-013443
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description Objective: 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.
published_date 2017-02-14T19:22:06Z
_version_ 1821343929462685696
score 11.04748

Similar Items