چکیده (انگلیسی):

Background:Provision of post stroke care in developing countries is hampered by discoordination of services and
limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less
than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems
among Family Medicine Specialists managing public primary health care services.
Methods:A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health
centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire
assessed respondents background and practice details i.e. estimated stroke care burden, current service provision
and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data,
constant comparison method was used until saturation of themes was reached.
Results:Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2
patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents
estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard
care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared
care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%).
Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on‘as needed’ basis. Referrals ranked in order of
frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The
FMS’ perceived 4 important‘needs’ in managing stroke patients at primary care level; access to rehabilitation
services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a
standardized guideline and family and caregiver support.
Conclusions:Post discharge stroke care guidelines and access to rehabilitation services at primary care is needed
for post stroke patients residing at home in the community.