Abstract HUP13: Assessing Patient Perceptions Of Strokes Reveals Limited Coherence And Perceived Barriers To Treatment Compliance In Hospitalized Stroke Patients Independent Of Race/ethnic And Socioeconomic Factors

Abstract

Introduction: A large factor contributing to stroke prevention is medication adherence and lifestyle adjustments. Patients' attitudes and perceptions towards health may contribute to a patient's likelihood of optimal stroke prevention. Methods: We surveyed hospitalized stroke patients and their caregivers using the Cerebrovascular Attitudes and Beliefs Scale-Revised and the Illness Perception Questionnaire-Revised survey before hospital discharge. Parametric and nonparametric tests were used to assess statistical significance, and Cronbach's was used for inter-rater variance using SPSS Statistics 27. Results: Our study included 39 patients & 6 caregivers, median age 66 (interquartile range 56-78), 60% woman, 69% Non-Hispanic White, 71% ischemic, 58% non-LVO, 4% tPA, 67% Medicare, 36% rural, and the median time since stroke onset was 3-5 days. Cronbach's alphas indicated that all sub-scales were reliable with a high level of internal consistency (α=0.829). More patients identified as having difficulty understanding their medical condition smoked (p=0.024), did not have atrial fibrillation (p=0.009), and did not have hyperlipidemia (p=0.036). Also, patients with diabetes were more likely to perceive obstacles to treatment compliance (p=0.039), prolonged recovery (p=0.042), and more severe consequences (p=0.046). Patients who had experienced a non-LVO were more likely to perceive the ineffectiveness of their treatments (p=0.034). More patients who had experienced a TIA perceived barriers to treatment compliance (p=0.049). Though there were no readmissions within 30 days and only one fatality related to GI bleed, of the 38% of patients that did not keep their post-hospital discharge follow-up neurology appointment, more had difficulty understanding their medical condition (p=0.036). There was no association with race, gender, insurance, rural vs. urban, or ethnicity. Conclusions: Interestingly, our findings identified modifiable stroke risk factors. We also saw a link between health care perceptions and no-show neurology clinic visits post-stroke hospitalization. Effective personalized patient education before hospital discharge is needed to help improve secondary stroke prevention management.