Abstract HUP14: Impact Of Socioeconomic Status And Race On The Access To Specialized Care And Enrollment/adherence In Clinical Trial In Cerebral Cavernous Malformations

• DOI: 10.1161/str.54.suppl_1.hup14
• Publication Date: 2023-02-02T10:16:12Z
• Authors: Stephanie F Hage; Matthew J Hagan; Agnieszka Stadnik; Justine Lee; Sharbel G Romanos; Abhinav Srinath; Robert Shenkar; Romuald Girard; Jianbo Hu; Connie Lee; Issam A Awad
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

Background: Cerebral cavernous malformation is a common lesion affecting more than million Americans, with potential severe sequelae. It unclear how socioeconomic status (SES) and race influence access to specialized care, the enrollment adherence in clinical trials aimed at novel therapies for CCM. Methods: We analyzed cohort of patients harboring CCM lesions screened IRB approved research studies between 01/2010 -12/2021 an accredited center excellence CCM, leading NIH funded studies. Demographics, location, history hemorrhage, insurance type area deprivation index (ADI) were collected. Insurance was categorized as commercial, Medicare/Medicaid, or out-of-pocket. The ADI ranking score per decile 1 (least disadvantaged) through 10 (most disadvantaged). Primary outcomes follow-up within year from st visit all (excluding pregnancy), enrollment/adherence among eligible subjects first disease trial [clinicaltrials.gov NCT02603328]. Statistical analysis (Chi 2 test; t-test) applied determine whether these differed groups, races categories. Results: Despite institution’s location majority African American population lower SES, only 11.5% American, (52.8%) had high SES (ADI 1-3). As expected, who symptomatic bleed likely (p=0.01), those brainstem enroll adhere (p=0.02). Correcting confounders, there no difference rates different coverage. Conclusion: Access disadvantaged care remains limited despite geographic proximity their community. Contrary belief, poor Americans are enroll/adhere trials, if provided care. Mitigation efforts should target systemic causes low patients.