Adherence to secondary stroke prevention medications in Singapore: a single center study.

Autor: Wong PS; Department of Pharmacy, Singapore General Hospital, Singapore; Department of Pharmacy, National University of Singapore, Singapore. Electronic address: phawps@nus.edu.sg., Narasimhalu K; Department of Neurology (Singapore General Hospital Campus), National Neuroscience Institute, Singapore., Tio SL; Department of Pharmacy, National University of Singapore, Singapore., Shankari G; Department of Neurology (Singapore General Hospital Campus), National Neuroscience Institute, Singapore; MOH Holdings Pte Ltd., Singapore., Doshi K; Department of Psychology, National University of Singapore, Singapore., De Silva DA; Department of Neurology (Singapore General Hospital Campus), National Neuroscience Institute, Singapore.
Jazyk: angličtina
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2024 Mar; Vol. 33 (3), pp. 107561. Date of Electronic Publication: 2024 Jan 07.
DOI: 10.1016/j.jstrokecerebrovasdis.2024.107561
Abstrakt: Objectives: Recurrent strokes are associated with greater disability and mortality than first-time strokes. However, adherence to secondary stroke prevention medications has been reported to be suboptimal. We assessed medication adherence to antihypertensives, antiplatelets, and statins after acute ischemic stroke and identified factors associated with non-adherence behavior to each drug class.
Methods: This single center study is an extension of a larger prospective cohort study of ischemic stroke patients assessed at an outpatient post stroke clinic. Medication adherence behavior and medication knowledge was determined by direct questioning, and perceptions towards medications via the Beliefs about Medicines Questionnaire. Factors associated with non-adherence in each drug class were determined using logistic regression.
Results: Rates of adherence differed between antihypertensives (77.9%), antiplatelets (80.3%), and statins (64.7%) (p < 0.001) amongst the 193 patients surveyed. Non-adherence to antihypertensives was associated with living alone, taking < 5 medications, and stronger beliefs that medications are harmful. For antiplatelets, non-diabetic patients and patients with stronger beliefs that medications are harmful were more likely to be non-adherent. Patients non-adherent to statins were more likely to have a longer time since ischemic event and have a transient ischemic attack as the index event.
Conclusions: Overall, medication adherence behavior to secondary stroke prevention medications was poor, with statins the least adhered to. Factors associated with non-adherence to each drug class could guide the development of tailored interventions to improve adherence to secondary stroke prevention medications.
Competing Interests: Declaration of competing interest All authors report no conflicts of interest.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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