Abstract Background and aims Secondary prevention following Stroke/TIA is a core priority for the NHS, with an emphasis on blood pressure (BP) control, lipid optimisation, atrial fibrillation (AF) management, and holistic long-term support. However, little is known about patient understanding, experience, and perceived residual risk in rural primary care settings. The aim was to evaluate patient-reported understanding, goal-setting, treatment burden, quality of life, and support needs following CVA. Methods Anonymised electronic questionnaire was distributed to primary care patients with a history of stroke/TIA in rural England. Ethical approval was obtained. Quantitative data were analysed descriptively, and free-text responses underwent thematic analysis to capture patient experience. Results Of 102 respondents, 91 (89.2%) consented to participate and were predominantly aged ≥65years (76.4%). While most reported some understanding of stroke causation and prevention, substantial gaps were identified: 54.1% were unsure whether BP or LDL-cholesterol targets had been set, 64.9% not knowing BP target, and 86.3% did not know their LDL-cholesterol target. AF was reported by 35.1%, yet 28.4% did not understand its relationship to stroke risk. Quality of life declined following stroke/TIA (weighted mean 1.90 pre-event vs 2.57 post-event), fatigue, mobility, and emotional well-being most affected. Qualitative responses highlighted anxiety about recurrence, lack of structured follow-up, and reliance on “tablets only” without clear preventive education. Conclusions Despite high self-reported medication adherence, rural primary care stroke/TIA survivors demonstrate limited awareness of treatment targets and residual risk. Structured, goal-based secondary prevention reviews and improved patient education are needed to support NICE-aligned, patient-centred care and reduce recurrent vascular events. Conflict of interest VS Nil
Scott et al. (Fri,) studied this question.