A mixed methods study exploring inter-professional roles in the provision of UK outpatient TIA Services

Abstract

Background: Suspected transient ischaemic attack (TIA) is a diagnostic challenge yet requires timely diagnosis for secondary stroke prevention.
Aims: To understand variability of organisational processes, roles, education, and clinical decision-making in UK TIA services.
Methods: Healthcare professionals were surveyed online in 2021 with descriptive data analysis. We conducted interviews (2021-2022) with a purposive sample. Three researchers thematically analysed interview data.
Findings: Survey responses were received from 43 TIA services. 70% conducted remote consultations, 28% face-to-face, and 2% mixed. Different physician and roles, skills and experience provided TIA services. All services involved a consultant physician with experience in stroke. Ten interviews confirmed the survey results and highlighted variability regarding: clinical decision-making; service composition; resources; learning opportunities; and mode of consultation.
Conclusion: Variability in TIA service workforce and service organisation influenced diagnostic decisions. The possible impact of such variability on clinical outcomes, and approaches to reducing it, require further research.