What is the impact of team-based interventions on risk factor control and secondary prevention after ischemic stroke and TIA?
Additional ongoing and recently completed randomized trials are evaluating the impact of team-based interventions on risk factor control and secondary prevention after ischemic stroke and TIA.833 838 In the FASTEST study (Efficacy and Safety of a Transient Ischaemic Attack [TIA] Electronic Support Tool) conducted in New Zealand, use of an electronic decision support tool for TIA and stroke management by general practitioners was compared with usual care for patients presenting to their general practitioner as first care contact after stroke or TIA. The tool was designed to improve diagnostic accuracy, to support appropriate triage, and to guide providers in appropriate medication and nonpharmacological (lifestyle counseling) management. TIA and stroke recurrence at 90 days was significantly lower in the intervention group compared with the usual care group, and patients receiving the intervention were more likely to receive guideline- adherent care. This study provides evidence for the use of an electronic decision support tool to guide primary care providers in the management of TIA or minor stroke. 