Abstract WP424: Prevalence and Determinants of Non-adherence to Secondary Preventive Medication in Stroke Patients
Introduction: Nonadherence to secondary preventive medication is associated with adverse outcomes and higher costs of care in stroke patients. The purpose of this study is to investigate the prevalence and major determinants of nonadherence to secondary preventive medication in stroke survivors.
Hypothesis: We assessed the hypothesis that the determinants of nonadherence to secondary preventive medication in stroke patients may be different in both intentional and nonintentional, or/and in various classes of medication.
Methods: We enrolled the 252 patients taking medicines > 1 year after stroke onset. Adherence was measured by a self-reported questionnaire, and nonadherence was classified to be intentional (e.g., deliberately choosing not to take medicines or to change medication dosage, three items) or unintentional (e.g., forgetting to take medication, four items). The devices to assess the determining factors of adherence included Belief about Medication Questionnaire, Morisky Medication Adherence Scales, Lubben Social Network Scale-6, and Geriatiric Depression Scale. We also conducted a survey to assess healthy adherence effects and satisfaction level of education program about medication and healthy behaviors.
Results: About 60% of patients were non-adherent (n=150, 59.5%). Among them, 56 (37.3%) patients were unintentionally and 94 (62.7%) patients were intentionally nonadherent to their stroke preventive medication. The determinants of nonadherence were age [Exp(B)=1.041, p=0.045], necessity [Exp(B)=1.106, p=0.057], social network [Exp(B)=1.021, p=0.044] and familial support [Exp(B)=1.032, p=0.044]. Classic oral anticoagulation therapy showed better adherence compared with antiplatelet therapy (83.6% vs. 69.7%, p=0.002). The behavioral education was a determinant for adherence to the classic oral anticoagulation therapy.
Conclusion: In conclusion, nonadherence to medication in stroke surviviors was generally high. Necessity was an important determinant of both intentional and unintentional nonadherence. Older age was predictive of unintentional nonadherence, and building social networks and familial support were important for the intentionally nonadherent patients.
Author Disclosures: S. Kim: None. D. Jeong: None. N. Choi: None. R. Kim: None. K. Park: None. S. Son: None.
- © 2016 by American Heart Association, Inc.