Grant: O. Gr.: Addr. the Health Impacts of COVID-19 - Imp. of def/disp care on health

Every 9 minutes, someone in Canada experiences a stroke. Stroke is the third most common cause of death among Canadians. The COVID19 pandemic has affected stroke care in many ways. First, infection with the coronavirus is associated with an increased risk of stroke. Second, the pandemic-related restrictions could affect people's ability to renew their regular medications on time, including those that are important for stroke prevention like blood thinners or medications to control blood pressure, diabetes, or cholesterol. Third, despite the new and widespread use of telemedicine for doctor visits since the beginning of the pandemic, it is not clear if all regular care after a stroke can be maintained through video or telephone calls. Certain patients may be particularly vulnerable to difficulties with telemedicine, including those who are older, women, those who experience socioeconomic deprivation, or who live in rural regions. These are the questions we are proposing to study. Given COVID19 has affected Canadian provinces differently, we will be studying the stroke care and outcomes in Alberta, Ontario, and Nova Scotia. We will use routinely collected administrative health data in this study. In each province, we will make comparisons before and after the pandemic. We will 1) evaluate whether the number of stroke hospitalizations has increased, 2) report whether Canadians are more likely to have interruptions in their medications, and 3) study the uptake of telemedicine visits after stroke and how patients with stroke are faring. Our research team will be working closely with provincial and national policymakers and stroke organizations. This study will help the health system prepare for any anticipated increase in stroke cases in Canada and plan for the optimal delivery of health care to ensure excellent and equitable stroke care and prevention.