Abstract Number: Esoc2026a2212 a Goal-Directed, Digitally Enabled Paradigm for Secondary Stroke Prevention in Rural Primary Care

Abstract Background and aims In England, primary care delivers most long-term care for survivors of CVA/TIA, particularly in rural areas with ageing populations and high multimorbidity. While the QoF supports minimum standards, it does not consistently promote holistic, patient-centred care or address residual risk. Traditional restorative models focused on disease control and are insufficient for post-stroke management. Methods Patient experience data from a rural CVA/TIA population, along with high mobile device access, led us to implement a goal-directed care paradigm prioritising quality of life, functional outcomes, and cardiovascular risk reduction. Management integrated blood pressure, lipid control, BMI, AF, and common comorbidities, including CKD, diabetes, liver disease, obesity, and COPD. Patient-facing digital e-tools include ACCURX and e-leaflets, aligned with NICE and European stroke and co-morbid condition guidance, and disseminated via mobile-enabled platforms. Results The paradigm shifts care from protocol-and resolution-driven processes to patient-oriented goals that address safety, function, psychological well-being, education, and self-management. Digital dissemination/assessments enabled scalable delivery of consistent, evidence-based data across a geographically dispersed rural population whilst complementing face-to-face and telephone reviews. Early qualitative feedback indicates improved patient understanding of cardiovascular risk, treatment targets, and the impact of multimorbidity on recurrent events. Conclusions A goal-directed paradigm supported by simple digital tools offers a pragmatic, equitable approach to secondary stroke prevention in rural primary care. Integrating restorative and supportive models may better meet the needs of ageing patients living with CVA/chronic disease(s) whilst enhancing shared decision-making and helping close the confidence-comprehension and care gaps. Conflict of interest Dr C Deaney has received honoraria/grants from Amarin, Amenarini, AZ, Chiesi, Daiichi Sankyo, Ferring, GSK, Idorsia, Novartis, and Novo Nordisk.