Care seeking after stroke symptoms.
OBJECTIVE
To assess risk factors associated with care for stroke symptoms.


METHODS
Using data from the population-based national cohort study (REasons for Geographic And Racial Differences in Stroke) conducted January 25, 2003-February 28, 2007 (N = 23,664), we assessed care-seeking behavior among 3,668 participants who reported a physician diagnosis of stroke/transient ischemic attack (n = 647) or stroke symptoms (n = 3,021) during follow-up. Care seeking was defined as seeking medical attention after stroke symptoms or a physician diagnosis.


RESULTS
Overall, 58.5% of participants (2,146/3,668) sought medical care. In multivariable models, higher income was associated with greater likelihood of seeking care (p = 0.02): participants with income of > or = $75,000 had odds 1.43 times (95% confidence interval [CI], 1.02-2.02) greater than those with income of less than $20,000. Diabetes and previous heart disease were associated with increased care seeking: odds ratio (OR) of 1.23 (95% CI, 1.04-1.47) and OR of 1.26 (95% CI, 1.06-1.49), respectively. Participants with previous stroke symptoms but no stroke history were less likely to seek care than those with stroke history or without previous symptoms (OR, 0.80; 95% CI, 0.67-0.96). Past smoking was associated with lower likelihood (OR, 0.71; 95% CI, 0.59-0.85; p = 0.0003) of seeking care relative to nonsmokers.


CONCLUSIONS
Only approximately half of participants with stroke symptoms sought care. This is despite the encouragement of advocacy groups to seek prompt attention for stroke symptoms. Our results highlight the importance of identifying characteristics associated with care-seeking behavior. Recognizing factors that contribute to delays provides opportunities to enhance education on the importance of seeking care for stroke symptoms.
Howard
Virginia J
VJ
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA.
Lackland
Daniel T
DT
Lichtman
Judith H
JH
McClure
Leslie A
LA
Howard
George
G
Wagner
Libby
L
Pulley
Leavonne
L
Gomez
Camilo R
CR
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000191:economics / Q000453:epidemiology* / Q000628:therapy*; D014481:United States / Q000453:epidemiology