The Stroke Foundation’s ‘FAST’ campaign to encourage stroke patients to call triple zero is paying off, with new figures showing a big swing to patients using emergency services rather than visiting a GP for symptoms.

The Foundations’ advertising campaign started in 2004 and used the FAST (Face, Arm, Speech, Time) message from 2006 to encourage people to recognise suspected stroke symptoms and dial 000 immediately.

Now a study of 73,607 stroke and 44,393 TIA  presentations at 33 emergency departments in Victoria has found that the campaign resulted in a significant increase in the proportion of patients arriving directly by emergency medical services (EMS) while the rate of referrals from GPs more than halved.

Compared to rates before the FAST campaign, significant increases in EMS use for stroke patients were seen annually, peaking in 2009 and staying constant at around 14-19% higher than before the campaign (Odds Ratio 1.16 in 2015).

Over the same period, the number of stroke patients referred by GPs declined to about half of the pre-campaign level, with an Odds Ratio of 0.48 in 2015.

The study authors expressed concern over the low rate of EMS referrals by GPs, ranging from 30% in 2003 to 15% in 2015.

“A high proportion of these patients are probably minor strokes and TIAs, who tend to report lower rates of FAST symptoms and may misinterpret the cause of their symptoms. However, whether these patients require an emergency response is unknown. Given the risk of recurrent stroke, careful triage by GPs is required,” they wrote in Stroke.

The researchers said the findings showed the Stroke Foundation’s FAST campaign had been a success, but novel approaches were now needed because the campaign impact had hit a “ceiling” within a few years.

They suggested that future stroke symptom campaigns target groups who are still not calling triple zero, such as younger adults, rural residents and people from non-English speaking backgrounds.