In keeping with a preliminary study published today, February 28, 2024, which will likely be presented on the American Academy of Neurology 76vol Annual meeting April 13-18, 2024, in person in Denver and online. The study checked out individuals who had had an ischemic stroke, which is brought on by blockage of blood flow to the brain and is essentially the most common sort of stroke.
Any barriers that prevent stroke survivors from taking clot-busting drugs, the so-called thrombolytic therapy, can have devastating consequences. “Our study found that a lot of aspects influence whether an individual receives this significant treatment, including race, insurance status, place of residence and other social determinants of health.”
Chanaka Nadeeshan Kahathuduwa, MD, PhD, MPhil, writer of the study Texas Tech University Health Sciences Center in Lubbock and Fellow of the American Academy of Neurology
The study included 63,983 individuals with ischemic stroke identified in Texas public health records. Regarding race and ethnicity, 67% of participants were white, 18% were black, and 27% were Hispanic, with some participants having a couple of race and ethnicity.
The researchers found that 7,198, or 11%, received clot-busting drugs.
Researchers then checked out social aspects which will impact an individual’s health, akin to income, education, housing and access to health services. To rank participants based on these aspects, U.S. Census data was used and a measure called the Social Vulnerability Index was used. They divided the participants into 4 groups.
Of the 7,930 people within the group identified as least disadvantaged, 1,037 received clot-busting drugs. Of the 7,966 people within the group identified as most disadvantaged, 964 received clot-busting drugs.
After adjusting for age, gender and education, researchers found that the least disadvantaged people were 13% more more likely to receive clot-busting drugs than those in other groups.
Looking specifically at race and ethnicity, black people were 10% less more likely to receive this therapy than white people. Latinos were 7% less more likely to receive this therapy in comparison with non-Hispanics.
When taking a look at insurance coverage, researchers found that individuals on Medicare, Medicaid or Veterans Assistance and those that were uninsured were 23% and 10% less likely, respectively, to receive clotting-suppressing drugs than those with private insurance.
After analyzing location, researchers found that participants living in rural areas were 40% less more likely to receive treatment than those living in urban areas.
“Our results are disturbing and make clear health care disparities,” Kahathuduwa said. “This study shows how unfavorable social conditions can translate into poorer stroke care. Further research is required to look at the connection between society, the health care system, and stroke outcomes. Finding recent approaches to handle these social aspects is important to improving equity in stroke care and recovery.”
Kahathuduwa noted that clot-busting drugs needs to be administered inside hours of the onset of stroke symptoms. A limitation of the study was that it was unknown what number of participants visited the hospital during this time-frame and were subsequently eligible for treatment.
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