ABSTRACT NUMBER: ESOC2026A942 PREDICTORS OF PATIENT SATISFACTION WITH OPTIMAL CARE QUALITY AFTER ACUTE ISCHAEMIC STROKE: INSIGHTS FROM THE OPTIMISTMAIN STUDY

Abstract Background and aims Patient-reported experience measures (PREMs) are key metrics of healthcare quality, yet determinants of superior patient experiences in stroke care remain unclear. This study examined predictors of optimal satisfaction among patients with mild to moderate acute ischemic stroke (AIS) during hospitalisation. Methods A secondary analysis of OPTIMISTmain, an international, stepped-wedge, cluster-randomised trial, comparing low-intensity monitoring with standard monitoring. Participants completed a PREMs survey at day 7 or before discharge. Overall care quality (5-point Likert Scale) was dichotomised into “optimal” (highest rating) and “suboptimal”. Mixed-effects logistic regression identified predictors of optimal PREM, with subgroup analysis by randomisation. Results Of the 3,676 AIS patients with available data, 3,029 (82.40%) reported optimal care quality. Low-intensity monitoring group were more likely to have an optimal rating compared to the standard monitoring (55.4% vs. 44.6%). The strongest predictors were “feeling cared for” (adjusted odds ratio [aOR]: 5.33, 95% confidence interval [CI]: 2.38-11.93, P<0.001), followed by “being kept informed about treatment” (aOR: 5.12, 95% CI: 3.25-8.07, P<0.001) and “perceived staff coordination” (aOR: 4.36, 95% CI: 2.32-8.19, P<0.001). Greater stroke severity (NIHSS ≥5) reduced the odds of optimal care quality (aOR: 0.73, 95% CI: 0.58-0.93, P=0.009). Subgroup analysis confirmed these findings; however, “individual needs being met” was a strong predictor only in the low-intensity group (aOR 4.19, 95% CI 1.97–8.91, P<0.001). Conclusions Optimal AIS care quality is driven by humanistic factors, including emotional support, clear communication, and coordinated care. Low-intensity monitoring did not compromise experience, but patients with greater severity and unmet needs were less satisfied. Conflict of interest None