Awareness on diagnosis and management of transient ischemic attacks (TIA) among Sri Lankan doctors

Abstract

INTRODUCTION: Patients with Transient Ischemic Attacks (TIA) are at high risk of recurrent strokes and the risk can be predicted using clinical scoring systems. However, there is no data on doctors’ awareness on TIA diagnosis/management in Sri Lanka. OBJECTIVE: To assess awareness of doctors on diagnosis and management of TIA. METHOD: Therefore, we assessed awareness on diagnosis/management of TIA among first-contact (outpatient department (OPD)) and second-contact (Medical ward) doctors of a tertiary care hospital in Sri Lanka in an observational-study using self-administered questionnaires. RESULTS: 29 OPD (mean-age 44.6±10.3years, female-55.2%) and 24 medical ward doctors (mean-age 35.2 ±10.0years, female-79.2%) volunteered for the study. 28.3% had some post-graduate experience. 47.1% used to attend Continuous Medical Education (CME) activities. Although all doctors were familiar with the word TIA, only 26.4% knew the correct clinical definition of a TIA. 71.7% had heard about TIA-scoring systems. Compared to 13.8% OPD doctors, 45.8% of Medical ward doctors knew what is denoted by ABCD2 in the TIA-score. However, only 15.1% knew the correct cut-off for diagnosis of high risk TIAs using ABCD2 score. 60.4% appreciated that TIA management changes with risk of stroke recurrence predicted by ABCD2-score. 78.0% were informed that TIAs need brain imaging. Even though 69.8% were aware to give aspirin as emergency treatment for TIAs, less OPD doctors (27.6%) were aware that aspirin can be given without brain imaging compared to medical ward doctors (50%). CONCLUSIONS: Awareness on TIA diagnosis/management of this group of Sri Lankan doctors seems inadequate. Therefore there is room for reducing burden of strokes in Sri Lanka by improving doctors’ awareness on diagnosis/management of TIA.