Management of stroke patients by general practioners: An observational study.

OBJECTIVE: Post-stroke medical management, defined by national and international guidelines, involves many professionals, allowing optimal secondary prevention. The general practitioner is as a major player in this management. The improved of this management appears as the new challenge following the stroke Plan 2009-2014. The aim of this study was to evaluate the medical and paramedical management of patients in the year following a stroke.

MATERIAL/PATIENTS AND METHODS: This was an observational study among general practitioners of stroke patients in Aquitaine. One hundred and fifty-two general practitioners were contacted and 80 answered to a standardized telephone interview on medical and paramedical management during the year following the stroke of their patient. We collected different sociodemographic, anamnestic, and clinical data, such as quality of life, participation restrictions or cognitive impairment. "Recommended management", defined as at least one consultation with a neurologist, was our main criterion.

RESULTS: Forty-two patients (52.5%) had a consultation with a neurologist, 66 (82.5%) with a cardiologist, 5 (6.3%) with PRM doctor, 4 (5%) with a geriatrician, 5 (6.3%) with a psychiatrist. The recommended management was correlated to Rankin score (P=0.016), total EQ5D score (P=0.04), and nursing care (P=0.013).

DISCUSSION - CONCLUSION: Our results highlight the heterogeneity in the medical care of stroke patients, with failure for patients with mild handicap or disabilities. This medical and paramedical management is now defined by new national guidelines, leading to the creation of a multidisciplinary consultation. The general practioner remains a major player in this support, in association with multidisciplinary reference units, and the links between these two worlds need to be strengthened.