Secondary prevention among uninsured stroke patients: A free clinic study

MacDonald, Madeline; Zarriello, Sydney; Swanson, Justin; Ayoubi, Noura; Mhaskar, Rahul; Mirza, Abu-Sayeef

doi:10.1177/2050312120965325

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…Lastly, being uninsured was associated with higher language performance. This contradicts previous findings where having insurance improved stroke outcomes particularly in the outpatient setting where substantial rehabilitation occurs [ 59 ]. It is tenable that many of the uninsured were younger (under at 65 thus not covered by Medicare).…”

Section: Discussioncontrasting

confidence: 99%

Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

Jacobs,

Evans,

Ellis

2024

PLoS ONE

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Introduction Traditionally, the study of aphasia focused on brain trauma, clinical biomarkers, and cognitive processes, rarely considering the social determinants of health. This study evaluates the relationship between aphasia impairment and demographic, socioeconomic, and contextual determinants among people with aphasia (PWA). Methods PWA indexed within AphasiaBank—a database populated by multiple clinical aphasiology centers with standardized protocols characterizing language, neuropsychological functioning, and demographic information—were matched with respondents in the Medical Expenditure Panel Survey based on response year, age, sex, race, ethnicity, time post stroke, and mental health status. Generalized log-linear regression models with bootstrapped standard errors evaluated the association between scores on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R AQ) and demographic, economic, and contextual characteristics accounting for clustering of respondents and the stratification of data collection. Region, age, and income specific models tested the sensitivity of results. Results PWA over age 60 had 2.4% (SE = 0.020) lower WAB-R AQ scores compared with younger PWA. Compared to White PWA, Black and Hispanic PWA had 4.7% (SE = 0.03) and 0.81% (SE = 0.06) lower WAB-R AQ scores, respectively, as did those and living in the Southern US (-2.2%, SE = 0.03) even after controlling for age, family size, and aphasia type. Those living in larger families (β = 0.005, SE = 0.008), with income over $30,000 (β = 0.017, SE = 0.022), and a college degree (β = 0.030, SE = 0.035) had higher WAB-R AQ relative to their counterparts. Region-specific models showed that racial differences were only significant in the South and Midwest, while ethnic differences are only significant in the West. Sex differences only appeared in age-specific models. Racial and ethnic differences were not significant in the high-income group regression. Conclusion These findings support evidence that circumstances in which individuals live, work, and age are significantly associated with their health outcomes including aphasia impairment.

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Section: Discussioncontrasting

confidence: 99%

Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

Jacobs,

Evans,

Ellis

2024

PLoS ONE

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“…[9][10][11] Uninsured and underinsured patients tend to have increased disability after stroke, are less likely to be discharged to inpatient rehabilitation, and may have minimal or no access to outpatient therapies following a stroke. [12][13][14] These reasons inspire us to advance technologies that can reach an increasingly isolated patient demographic.…”

Section: Introductionmentioning

confidence: 99%

aBnormal motION capture In aCute Stroke (BIONICS): A Low-Cost Tele-Evaluation Tool for Automated Assessment of Upper Extremity Function in Stroke Patients

Zamin,

Tang,

Stevens

et al. 2023

Neurorehabil Neural Repair

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Background The incidence of stroke and stroke-related hemiparesis has been steadily increasing and is projected to become a serious social, financial, and physical burden on the aging population. Limited access to outpatient rehabilitation for these stroke survivors further deepens the healthcare issue and estranges the stroke patient demographic in rural areas. However, new advances in motion detection deep learning enable the use of handheld smartphone cameras for body tracking, offering unparalleled levels of accessibility. Methods In this study we want to develop an automated method for evaluation of a shortened variant of the Fugl-Meyer assessment, the standard stroke rehabilitation scale describing upper extremity motor function. We pair this technology with a series of machine learning models, including different neural network structures and an eXtreme Gradient Boosting model, to score 16 of 33 (49%) Fugl-Meyer item activities. Results In this observational study, 45 acute stroke patients completed at least 1 recorded Fugl-Meyer assessment for the training of the auto-scorers, which yielded average accuracies ranging from 78.1% to 82.7% item-wise. Conclusion In this study, an automated method was developed for the evaluation of a shortened variant of the Fugl-Meyer assessment, the standard stroke rehabilitation scale describing upper extremity motor function. This novel method is demonstrated with potential to conduct telehealth rehabilitation evaluations and assessments with accuracy and availability.

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Antithrombotics prescription and adherence among stroke survivors: A systematic review and meta‐analysis

et al. 2022

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Objectives We aimed to investigate the prescription of antithrombotic drugs (including anticoagulants and antiplatelets) and medication adherence after stroke. Methods We performed a systematic literature search across MEDLINE and Embase, from January 1, 2015, to February 17, 2022, to identify studies reporting antithrombotic medications (anticoagulants and antiplatelets) post stroke. Two people independently identified reports to include, extracted data, and assessed the quality of included studies according to the Newcastle–Ottawa scale. Where possible, data were pooled using random‐effects meta‐analysis. Results We included 453,625 stroke patients from 46 studies. The pooled proportion of prescribed antiplatelets and anticoagulants among patients with atrial fibrillation (AF) was 62% (95% CI: 57%–68%), and 68% (95% CI: 58%–79%), respectively. The pooled proportion of patients who were treated according to the recommendation of guidelines of antithrombotic medications from four studies was 67% (95% CI: 41%–93%). It was reported that 11% (95% CI: 2%–19%) of patients did not receive antithrombotic medications. Good adherence to antiplatelet, anticoagulant, and antithrombotic medications was 78% (95% CI: 67%–89%), 71% (95% CI: 57%–84%), and 73% (95% CI: 59%–86%), respectively. Conclusion In conclusion, we found that less than 70% of patients were prescribed and treated according to the recommended guidelines of antithrombotic medications, and good adherence to antithrombotic medications is only 73%. Prescription rate and good adherence to antithrombotic medications still need to be improved among stroke survivors.

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Secondary prevention among uninsured stroke patients: A free clinic study

Cited by 3 publications

References 30 publications

Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

aBnormal motION capture In aCute Stroke (BIONICS): A Low-Cost Tele-Evaluation Tool for Automated Assessment of Upper Extremity Function in Stroke Patients

Antithrombotics prescription and adherence among stroke survivors: A systematic review and meta‐analysis

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