Reduced medication access: a marker for vulnerability in US stroke survivors

Area of Science:

• Public Health
• Cardiovascular Research
• Health Services Research

Background:

• Medication access is vital for secondary stroke prevention.
• Disparities in access and care barriers exist among US stroke survivors.

Purpose of the Study:

• To assess medication access and care barriers in a national sample of US stroke survivors.
• To examine changes in medication access across US regions and over time.

Main Methods:

• Analysis of the National Health Interview Survey (1997-2004) data.
• Inclusion of 5840 black or white stroke survivors aged 45 years and older.
• Logistic regression used to adjust for demographic, clinical, and socioeconomic factors.

Main Results:

• In 2004, an estimated 76,000 stroke survivors could not afford medications.
• Lower medication affordability was linked to younger age (<65), Black race, female sex, high comorbidity, and low health status.
• Barriers included lack of transportation, no health insurance, no usual place of care, low income, and high out-of-pocket expenses.
• Medication unaffordability increased from 8.1% in 1997 to 12.7% in 2004, with increases across most US regions.

Conclusions:

• A significant and growing population of stroke survivors faces reduced medication access and increased healthcare barriers.
• This trend may lead to a rise in recurrent stroke incidence.
• Targeted interventions are needed to address these access and care disparities.