Transient ischaemic attack services in New Zealand.

BACKGROUND

We conducted an audit of transient ischaemic attack (TIA) services in New Zealand to determine how current practice compares to best practice recommendations.

METHODS

A brief written questionnaire was sent to all district health boards (DHBs) concerning service provision, clinical management and clinical audit activity related to patients with TIA.

RESULTS

Questionnaires were completed by all 21 DHBs. In 18 of 21 (71%) DHBs, most TIA patients were managed by acute services; 3 (14%) DHBs routinely admit most patients and 15 (72%) see most patients in hospital emergency departments or acute assessment units. Three (14%) DHBs see most TIA patients in outpatient clinics, with a usual wait to be seen of more than 1 week. Delays of more than a week were common for carotid ultrasound scans (10 DHBs, 48%) and carotid endarterectomy when indicated (16 DHBs, 76%). Only 4 (19%) DHBs had audited TIA management at a patient level and 3 (14%) at a service level.

CONCLUSIONS

There are major discrepancies between current management of TIA patients and best practice recommendations in national and international guidelines. Significant regional variations in models of care and access to investigations exist. The provision of dedicated appropriately resourced TIA services within an organised stroke service should be seen as a priority.