Impact of an outpatient telestroke clinic on management of rural stroke patients

Objective Report on feasibility, use and effects on investigations and treatment of a neurologist‐supported stroke clinic in rural Australia. Design Data were collected prospectively for consecutive patients referred to atelehealth stroke clinic from November 2018 to August 2021. Settings, participants and interventions Patients attended the local hospital, with a rural stroke care coordinator, and were assessed by stroke neurologist over videoconference. Main outcome measures The following feasibility outcomes on the first appointments were analysed: (1) utility (a) change in medication, (b) request of additional investigations, (c) enrolment/offering clinical trials or d) other; (2) acceptability (attendance rate); and (3) process of care (waiting time to first appointment, distance travelled). Results During the study period, 173 appointments were made; 125 (73.5%) were first appointments. The median age was 70 [63–79] years, and 69 patients were male. A diagnosis of stroke or transient ischemic attack was made by the neurologist in 106 patients. A change in diagnosis was made in 23 (18.4%) patients. Of the first appointments, 102 (81.6%) resulted in at least one intervention: medication was changed in 67 (53.6%) patients, additional investigations requested in 72 (57.6%), 15 patients (12%) were referred to a clinical trial, and other interventions were made in 23 patients. The overall attendance rate of booked appointments was high. The median waiting time and distance travelled (round‐trip) for a first appointment were 38 [24–53] days and 60.8 [25.6–76.6] km respectively. Conclusion The telestroke clinic was very well attended, and it led to high volume of interventions in rural stroke patients.