Predictors of Persistence and Adherence with Secondary Preventive Medication in Stroke Patients.
10.5393/JAMCH.2015.40.1.009
- Author:
Young Taek KIM
1
;
Ki Soo PARK
;
Sang Geun BAE
Author Information
1. Division of Infectious Disease Control, Centers for Infectious Disease Control, Korea Centers for Disease Control and Prevention, Korea.
- Publication Type:Original Article
- Keywords:
Stroke;
Persistence;
Adherence;
Belief;
Depression
- MeSH:
Depression;
Health Education;
Health Personnel;
Humans;
Secondary Prevention;
Stroke*
- From:Journal of Agricultural Medicine & Community Health
2015;40(1):9-20
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: This study aimed to explore the persistence and adherence to secondary preventive medication of stroke patients after discharge and to assess the reasons for persistence and nonadherence. METHODS: Four hundred twenty-nine patients with stroke were surveyed to determine their behaviors from discharge. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications according to health care provider instructions. RESULTS: Of the 429 patients, 86.5% were treatment persistent and 41.2%(non-intentional nonadherence=39.4%, intentional nonadherence=19.4%) were adherent. Independent predictors of persistence included having experience about health education. Independent predictors of non-intentional nonadherence were modified Rankin Scale(mRS) (Exp(B)=2.858, p=0.001) and health education experience (Exp(B)=0.472, p=0.032), and independent predictors of intentional nonadherence were mRS (Exp(B)=2.533, p=0.006), depressive symptoms (Exp(B)=1.113, p=0.016), beliefs about medications questionnaire(necessity, Exp(B)=0.879, p=0.011, concern, Exp(B)=1.098, p=0.019). CONCLUSIONS: Although up to one-ninth of stroke patients continued secondary prevention medications, nonadherence is common. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions. Specially, interventions to improve adherence should target patients' beliefs about their medication.
