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BACKGROUND: Stroke is a leading cause of morbidity and mortality. Timely recognition and referral are essential for treatment. AIM: To examine the ability of receptionists in general practices to recognise symptoms of stroke and direct patients to emergency care. DESIGN AND SETTING: Unannounced simulated patient telephone calls and prospective cross-sectional survey study in general practices in the Birmingham and Solihull area. METHOD: A total of 52 general practices participated in a total of 520 simulated telephone calls, with 183 receptionists completing questionnaires. Logistic regression analyses were used to examine likelihood of referral for immediate care by ease of vignette recognition and number of common stroke symptoms present. RESULTS: General practice receptionists correctly referred 69% of simulated calls for immediate care. Calls classed as 'difficult' to recognise were less likely to be immediately referred. Compared with 'easy' calls: 'difficult' calls odds ratio (OR) 0.15, 95% confidence interval (CI) = 0.08 to 0.26; 'moderate' calls OR 0.55, 95% CI = 0.32 to 0.92. Similarly, calls including one or two 'FAST' symptoms were less likely to be referred immediately (compared with three FAST symptoms: one symptom OR 0.30, 95% CI = 0.13 to 0.72; two symptoms OR 0.35, 95% CI = 0.15 to 0.83). CONCLUSION: General practice receptionists refer patients with stroke for immediate care when they present with several symptoms; however, they are less likely to refer patients presenting with only one symptom or less common symptoms of stroke. Optimum management of acute stroke in primary care requires interventions that improve receptionists' knowledge of lesser-known stroke symptoms.

Original publication

DOI

10.3399/bjgp15X685621

Type

Journal article

Journal

Br J Gen Pract

Publication Date

07/2015

Volume

65

Pages

e421 - e427

Keywords

general practice, health services administration, medical receptionists, patient simulation, questionnaires, stroke, Cross-Sectional Studies, Humans, Medical Receptionists, Morbidity, Patient Simulation, Primary Health Care, Prospective Studies, Referral and Consultation, Stroke, Surveys and Questionnaires, Telephone, United Kingdom