Access to stroke prevention clinics uneven across Canada: study

Although the vast majority of Canadians live within an hour drive of a stroke prevention program, access to the crucial health service varies greatly in some provinces, a new study has found.

Those findings, presented this weekend at the Canadian Stroke Congress in Quebec City, have been mapped out for the first time to highlight the disparities in access to stroke prevention services across the country.

Researchers found that, while 98 per cent of Ontario residents live within an hour drive of a stroke prevention clinic, that number is lower in Saskatchewan and drops off significantly in some Atlantic provinces.

In Saskatchewan, 70 per cent of the population lives within an hour of a stroke prevention program. In Newfoundland and Labrador, that proportion is only 53.7 per cent. And it’s even lower in New Brunswick, where less than 40 per cent of residents have the same kind of access.

Ontario, New Brunswick and Newfoundland and Labrador represent the "extremes," and the other provinces fall somewhere in between, said study co-author Patrice Lindsay, director of stroke at the Heart and Stroke Foundation.

Nationwide, 89.9 per cent of the population live within an hour drive of a stroke prevention program, the study found.

The full data and maps associated with the study will be published at a later date, Lindsay said.

"Before this study, we really didn’t know where (all the stroke prevention services) were in Canada and what access people had," she told CTVNews.ca in a phone interview.

Stroke prevention programs, whether they are provided in hospitals, community clinics or other locations, mainly help people who have already suffered a stroke or a transient ischemic attack, commonly referred to as a "mini-stroke."

After the first stroke, there’s a risk of another one occurring in as little as 48 hours, Lindsay said. Those follow-up strokes tend to be more severe and increase a patient’s risk of dementia, she added.

"That’s why it’s really important for people to have a prevention plan in place."

However, the study shows that some Canadians face geographic and diagnostic barriers when it comes to following those prevention plans. Even those who do live within a reasonable distance of a stroke prevention clinic may find that it’s only open on certain days and during certain hours, Lindsay said.

Access to specialists and diagnostic equipment, such as CT scanners, also varies from region to region, she said.

Lindsay says inadequate access to care is a contributing factor when it comes to stroke mortality rates, but more research needs to be done to see how many recurrent strokes are happening in each province and whether that can be directly linked to the availability of prevention programs.

She said provinces must find "creative ways" to make sure that patients have timely access to preventative care, and recruit enough physicians and health care professionals with stroke expertise to "share the load" at understaffed clinics. Identifying patients who are at a high risk of stroke or follow-up strokes is also key, she said.

"There is a huge impact on the system if we get this right," Lindsay said. "Prevention is our strongest weapon and we’re not using it to its fullest."

According to the Heart and Stroke Foundation, 62,000 strokes occur in Canada each year. Each year, more than 13,000 Canadians die from stroke.

More than 400,000 Canadians are currently living with stroke-related long-term disabilities and that number is expected to increase to 726,000 in the next 20 years.