Wolters FJ, et al. - The association of public education with delays and failure in seeking medical attention after a transient ischemic attack (TIA) and minor stroke was examined in this prospective population-based study. Researchers reported that extensive Face, Arm, Speech, Time (FAST)-based public education had not improved the response to TIA and minor stroke in the United Kingdom in contrast to a major stroke. Therefore, highlighting the need for campaigns that were tailored to transient and less severe symptoms.

Methods

• Study participants had TIA or stroke who sought medical attention between April 1, 2002, and March 31, 2014, registered at 9 general practices in Oxfordshire, United Kingdom.
• From July 1, 2013 to March 2, 2015, data analysis took place.
• Face, Arm, Speech, Time (FAST) public education campaign in the United Kingdom was the analyzed exposure in this investigation.
• Number of early recurrent strokes in patients who delayed or failed to seek medical attention, as well as the odds of seeking urgent attention after TIA and minor stroke before vs after initiation of the public education campaign were the main outcomes and measures.

Results

• According to the findings, among 2,243 consecutive subjects with first TIA or stroke (mean [SD] age, 73.6 [13.4] years; 1,126 [50.2%] female; 96.3% of white race/ethnicity), 1,656 (73.8%) had a minor stroke or TIA.
• Patients with major stroke more often sought medical attention within 3 hours of the event (odds ratio [OR], 2.56; 95% CI, 1.11-5.90; P=.03) after participating in the FAST campaign.
• No improvement was found in use of emergency medical services (OR, 0.79; 95% CI, 0.50-1.23; P for interaction = .03 vs major stroke) or time to first seeking medical attention within 24 hours (OR, 0.75; 95% CI, 0.48-1.19; P for interaction = .006 vs major stroke) for TIA and minor stroke.
• Data reported that patient perception of symptoms after TIA and minor stroke was correlated with more urgent behavior, but correct perception declined after the FAST campaign (from 37.3% [289 of 774] to 27.6% [178 of 645]; OR, 0.64; 95% CI, 0.51-0.80; P < .001).
• It was noted that 188 patients had a stroke within 90 days of their initial TIA or stroke, of whom 93 (49.5%) followed unheeded TIAs for which no medical attention was sought, similar before and after the FAST campaign (43 of 538 [8.0%] before vs 50 of 615 [8.1%] after, P=.93).