ABSTRACT NUMBER: ESOC2026A1571 DETERMINANTS OF GENERAL PRACTITIONER FOLLOW UP AFTER STROKE: THE SOUTH LONDON STROKE REGISTER

Abstract Background and aims Stroke survivors require follow-up for secondary prevention and complication management. This study determined GP follow-up one-year post-discharge, temporal trends and associated factors. Methods Population-based cohort study using the South London Stroke Register (1995-2024) of 8,458 people with first-ever stroke. Follow-up interviews at 3 months and 1-year assessed patient-reported GP contact, excluding deaths. Multivariable logistic regression examined demographic, socioeconomic, and clinical associations. Results Of 8,458 cases, 6,743 (79.7%) survived to 3 months and 6,183 (73.1%) to 1 year. Among 5,213 interviewed, 3,395 (65.1%) received GP follow-up. Three-month follow-up peaked at 98.4% (2008), declined to 30.2% (2024), dropping sharply between 2019-2022. One-year follow-up peaked at 86.4% (2003), declining to 34.5% (2023) (both P<0.001). Higher follow-up rates were associated with White ethnicity (66.8% vs 60.8% Black African), passing swallow assessment (68.0% vs 56.4%), ischemic stroke (65.9% vs 60.4%), pre-stroke independence (65.5% vs 57.3%), and normal consciousness (65.8% vs 60.4%). In adjusted analysis, Black survivors had reduced follow-up odds (OR 0.73, 95% CI 0.63-0.85, P<0.001), particularly Black African survivors (OR 0.66, 95% CI 0.55-0.80, P<0.001). Lower area deprivation (OR 0.70, P<0.001) and higher education (P=0.003) were associated with lower follow-up. Passing swallow assessment had higher odds (OR 1.71, 95% CI 1.44-2.02, P<0.001). Stroke unit admission (P=0.001), swallow assessment performed (P=0.017), and shorter hospital stay (median 12 vs 20 days, P<0.001) were associated with higher follow-up. Conclusions Two-thirds of stroke survivors receive follow-up within one year, but ethnic disparities persist after adjusting for clinical and socioeconomic factors. These findings can guide targeted interventions for ethnic minorities. Conflict of interest Ismail Ismail: nothing to disclose, Camila Pantoja Ruiz: nothing to disclose, Evelyn Lim: nothing to disclose, Charles Wolfe: nothing to disclose, Matthew O'Connell: nothing to disclose, Eva Emmett: nothing to disclose, Iain Marshall: nothing to disclose , Ajay Bhalla: nothing to disclose,