Factors Influencing 1-Year Medication Adherence of Korean Ischemic Stroke Survivors
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Factors Influencing 1-Year Medication Adherence of Korean Ischemic Stroke Survivors Gye-Gyoung Kim 1 & Duck-Hee Chae 1 & Man-Seok Park 2 & Sung-Hee Yoo 1
# International Society of Behavioral Medicine 2020
Abstract Background Medication adherence is important for secondary stroke prevention. However, suboptimal adherence to medication among patients after stroke or transient ischemic attack is reportedly 30.9%. We assessed medication adherence of Korean stroke survivors within 1 year of acute ischemic stroke and identified factors that influence adherence. Methods We consecutively enrolled ischemic stroke survivors who visited the Department of Neurology of a university hospital from March 9 to June 15, 2016. Data were collected by face-to-face interviews using a structured questionnaire which assessed general characteristics, clinical characteristics, medication beliefs, social support, and depression. Medication adherence was measured using the 8-item Morisky Medication Adherence Scale. Multiple logistic regression was used to identify factors independently associated with medication adherence. Results Of the total 250 participants, 183 (73%) were in the optimal adherence group. Age (p = 0.035), smoking (p = 0.020), number of prescribed medicines (p = 0.037), frequency of daily doses (p = 0.040), and beliefs about medication (p < 0.001) were associated with medication adherence. Optimal medication adherence was associated with being a non-smoker (OR, 3.19; 95% CI, 1.29–7.87; p = 0.012), more prescribed medicines (OR, 1.27; 95% CI, 1.05–1.54; p = 0.014), less frequency of daily doses (OR, 0.37; 95% CI, 0.18–0.79; p = 0.010), and stronger beliefs about medication (OR, 1.09; 95% CI, 1.03–1.15; p = 0.004). Conclusion To improve medication adherence of stroke survivors, post-stroke care should focus on bolstering patients’ belief in the necessity of medication and encouraging lifestyle modifications, such as quitting smoking, as well as prescribing medicine with simple regimens. Keywords Stroke . Medication adherence . Secondary prevention
Introduction Stroke is the third leading cause of morality in Korea, following cancer and heart disease [1]. The burden of stroke amounted to approximately $3.8 billion in 2010 [2]. The number of stroke survivor is persistently increasing, while the incidence of hemorrhagic strokes continues to decline [3]. This may be due to lifestyle changes, which have exacerbated the impact of risk factors for stroke, such as hypertension, diabetes mellitus, and dyslipidemia [4–6]. Stroke is related to a high
* Sung-Hee Yoo [email protected]; http://orcid.org/0000–0002–0951–1670 1
College of Nursing, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Republic of Korea
2
Department of Neurology, Medical school, Chonnam National University, Gwangju, Republic of Korea
risk of mortality and recurrence, which aggravates the risk of disability or death. The risk of recurrence within 5 years of the first stroke event is nearly 30%, while that within 1 yea
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