2023 American Academy of Neurology Abstract Website

Objective:

Our primary aim was comparing provider and patient surveys regarding stroke care. Our secondary aim was comparing patient responses by race/ethnicity.

Background:

Race disparities exist in treatment, lived experiences, and outcomes of stroke survivors. Stroke providers and patients differ in values and concerns during recovery. Aligning patient and provider concerns may foster better therapeutic relationships.

Design/Methods:

A 28-question patient survey and 25-question provider survey were created to gain insight into experiences with stroke care at MedStar Georgetown University Hospital (MGUH). Of 200 patients admitted to MGUH stroke service from September 2021 to March 2021, 39 completed the patient survey. All 40 providers (physicians and nurses from emergency medicine, neurology and critical care) completed their provider surveys. Statistical analyses included Fisher’s exact test.

Results:

White patients were older and had higher education than racial/ethnic minority patients but similar health-insurance status. Providers were mostly white and female.

White patients agreed their health care team effectively communicated to understand their condition significantly more than minority patients (p=0.033). White patients perceived significantly more support from their health care team than minority patients (p=0.05).

Providers viewed managing chronic stroke effects (77%) and difficulty following lifestyle changes (46%) as the biggest challenges in patients’ long-term care. Racial/ethnic minority patients expressed concern with understanding stroke risk factors (35%) and responsibilities at work and home (35%). White patients reported concerns managing effects of their strokes (33%), risks of recurrence (25%), and worries about home responsibilities (25%).

Conclusions:

This pilot survey-based study demonstrated differences in care experiences and post-stroke concerns between white and racial/ethnic minority patients. Most providers viewed managing chronic effects as the biggest challenge for patients, which was more consistent with white patients. Racial differences between providers and minority patients may contribute to differences in long-term stroke concerns. Limited by sample size, a larger multi-center study is planned to increase generalizability.