Stroke can be devastating for individuals and their families. People from ethnic minority groups are up to twice as likely to have a stroke as white British people, and these happen at younger ages. Before a stroke, up to 1 in 5 people will have a warning ‘mini stroke’ (TIA); this can feel and look the same as a stroke, but symptoms resolve within 24h. Getting medical help after TIA is urgent even if symptoms have gone because the risk of stroke is greatest soon after a TIA. This risk can be greatly reduced for people who are seen and treated by specialists quickly after their TIA. Effective treatment for TIA relies on steps in the ‘TIA pathway’: seeking help; being referred to and attending clinic; accepting treatment and sticking to it. We will investigate ethnicity-based differences in these pathways and, working with people from diverse ethnic groups, make suggestions for improvement.
Background
Aims & Objectives
To investigate ethnicity-based inequalities in access to treatment for ‘mini-stroke’ (TIA). To work with patients, the public and people who design and deliver health services and suggest ways to make it easier for people from ethnic minority groups to get appropriate TIA care.
Methods
We plan 3 linked studies:
Study 1 will use electronic health record data from 11 million patients (which cannot be linked back to individuals). We will investigate if personal characteristics (ethnic group, age, sex, deprivation score) are related to TIA clinic referral or attendance after suspected TIA, and how they relate to stroke in the year following TIA clinic attendance.
Study 2. We will study TIA services in England to explore how these function for people from ethnic minority groups. We will talk to patients, their family carers, and staff working within TIA services. We will ask patients if we can observe TIA clinic appointments to see how they work. We will examine written and spoken information given to patients. We will ask people from ethnically diverse communities to talk to us about what they know and understand about seeking help for TIA.
Study 3. We will meet with patients, staff and the public to help us understand the findings of studies 1&2. We will hold a series of workshops with people who have had TIA/stroke, members of the community, healthcare workers and people who design healthcare services to discuss and agree what could make TIA pathways work better for people from ethnic minority groups.
Partners & Collaborators
Investigators
Dr Elizabeth (Tizzy) Teale
Dr Kate Best
Rahael Kuruvilla
Professor Andy Clegg
Dr Rahena Mossabir
Dr Tom Crocker
Dr Rebecca Hawkins
Collaborators:
Bradford Teaching Hospitals NHS Foundation Trust
University of Leeds
Different Strokes
Timescales
01/04/2025 – 31/05/2028
Funding agency
National Institute for Health and Care Research (NIHR) Health Services Delivery Research (HSDR)
Further information
This study is independent research funded by National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research (HSDR) Project: NIHR162550. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
For further information, please contact Dr Elizabeth Teale e.a.teale@leeds.ac.uk.