PT  - JOURNAL ARTICLE
AU  - Ruth M Mellor
AU  - James P Sheppard
AU  - Elizabeth Bates
AU  - George Bouliotis
AU  - Janet Jones
AU  - Satinder Singh
AU  - John Skelton
AU  - Connie Wiskin
AU  - Richard J McManus
TI  - Receptionist rECognition and rEferral of Patients with Stroke (RECEPTS): unannounced simulated patient telephone call study in primary care
AID  - 10.3399/bjgp15X685621
DP  - 2015 Jul 01
TA  - British Journal of General Practice
PG  - e421--e427
VI  - 65
IP  - 636
4099  - http://bjgp.org/content/65/636/e421.short
4100  - http://bjgp.org/content/65/636/e421.full
SO  - Br J Gen Pract2015 Jul 01; 65
AB  - Background Stroke is a leading cause of morbidity and mortality. Timely recognition and referral are essential for treatment.Aim To examine the ability of receptionists in general practices to recognise symptoms of stroke and direct patients to emergency care.Design and setting Unannounced simulated patient telephone calls and prospective cross-sectional survey study in general practices in the Birmingham and Solihull area.Method A total of 52 general practices participated in a total of 520 simulated telephone calls, with 183 receptionists completing questionnaires. Logistic regression analyses were used to examine likelihood of referral for immediate care by ease of vignette recognition and number of common stroke symptoms present.Results General practice receptionists correctly referred 69% of simulated calls for immediate care. Calls classed as ‘difficult’ to recognise were less likely to be immediately referred. Compared with ‘easy’ calls: ‘difficult’ calls odds ratio (OR) 0.15, 95% confidence interval (CI) = 0.08 to 0.26; ‘moderate’ calls OR 0.55, 95% CI = 0.32 to 0.92. Similarly, calls including one or two ‘FAST’ symptoms were less likely to be referred immediately (compared with three FAST symptoms: one symptom OR 0.30, 95% CI = 0.13 to 0.72; two symptoms OR 0.35, 95% CI = 0.15 to 0.83).Conclusion General practice receptionists refer patients with stroke for immediate care when they present with several symptoms; however, they are less likely to refer patients presenting with only one symptom or less common symptoms of stroke. Optimum management of acute stroke in primary care requires interventions that improve receptionists’ knowledge of lesser-known stroke symptoms.