Intended for healthcare professionals

Rapid response to:

Research

Influence of general practice opening hours on delay in seeking medical attention after transient ischaemic attack (TIA) and minor stroke: prospective population based study

BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1569 (Published 18 September 2008) Cite this as: BMJ 2008;337:a1569

Rapid Response:

Extending opening hours of general practices: the tip of an iceberg?

I read with interest the original work of Lasserson et al. [1]. The
results show elevated delay in seeking help after a TIA or minor stroke in
case of out of hours or weekend events. Less than one third of patients
used emergency departments (A&E) or called NHS Direct. Those results have
immediate implications for emergency service provision and public
education. In my opinion it is less a question of extended opening hours
of general practices than a question of regulating emergencies in general.

The authors in the part Method reported that socio-demographic data were
collected but did not take into account those potential confounding
factors in their analyses. What would have been of interest is to assess
the influence of socio-demographic characteristics (e.g; age, sex,
nationality, educational level, occupational activity, marital status,
financial resources) on the delay of help seeking and the attendance of
general practices, A&E or NHS direct service. Previous findings showed
that patient characteristics are predictive of healthcare seeking
behaviours [2]. Identifying profile of patients could help targeting the
right population group for the delivery of public health awareness
campaigns. Also further follow-up is required to determine long-term
outcome (e.g; recurrent stroke, mortality rate).

[1] Lasserson DS, Chandratheva A, Giles MF, Mant D, Rothwell PM.
Influence of general practice opening hours on delay in seeking medical
attention after transient ischaemic attack (TIA) and minor stroke:
prospective population based study. BMJ 2008;337:a1569.

[2] Byrne M, Murphy AW, Plunkett PK, McGee HM, Murray A, Bury G.
Frequent attenders to an emergency department: a study of primary health
care use, medical profile, and psychosocial characteristics. Ann Emerg Med
2003; 41:309-18.

Competing interests:
None declared

Competing interests: No competing interests

23 September 2008
Isabelle Pitrou
Public Health Practitionner (MD)
Fondation MGEN pour la Santé Publique, 3 square Max Hymans, 75015 Paris, France