Severe financial strain more than doubles risk of death among heart attack patients
Heart attack patients struggling to pay their monthly bills are less likely to fully recover, according to new findings published in JAMA Internal Medicine.[1]
“Between 5% and 7% of all older adults in the United States report severe financial strain, defined as substantial difficulty meeting monthly needs,” wrote first author Jason R. Falvey, PT, DPT, PhD, a specialist from the University of Maryland School of Medicine, and colleagues. “Severe financial strain among older adults is associated with lower medication adherence, which may negatively affect recovery for older adults following an acute myocardial infarction (AMI)."
The study’s authors tracked data from nearly 3,000 U.S. patients. All were 75 years old or older at the time of their AMI. Data came from SILVER-AMI trial, an observational study first completed back in June 2018.
Overall, 16.8% of patients facing severe financial strain had died after 180 days. This was much higher than the rates among patients with moderate financial strain (9.2%) and patients under no financial strain (7.2%).
After adjustments, the authors added, severe financial strain was linked to a 61% increase in a patient’s 180-day mortality risk. There was no such association with moderate financial strain and mortality.
“Screening for financial strain during admissions provides an opportunity for clinicians to probe for resource needs in an actionable way,” the authors wrote. “A positive screen could guide targeted referrals for community supports, such as transportation services, assistance with prescription drug co-payments, or durable medical equipment. These interventions likely need to be paired with state and local-level policy changes to maximally improve outcomes for financially strained older adults recovering from an AMI.”
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