Abstract TP177: Previous Stroke/TIA History is Associated With Low Medication Adherence in a Multi-ethnic Cohort of Stroke Survivors

Background: Medication nonadherence is a major problem and is an important mediator between the treatment and the outcome. Strict compliance with medication and life style modification are integral to secondary stroke prevention. Methods: Cross sectional survey among 240 stroke survivors within a post-stroke period of three months to one year was conducted. Interview based self-reported medication adherence was defined as consumption at least more than 80% of their medication, based on their last prescription. Medication adherence was calculated for five categories of medication; antiplatelets, antihypertensives, antidiabetics, statin and anticoagulants. Overall adherence was defined as adherence to all the categories of medications prescribed. Structured interview using pretested interview schedule was done to collect sociodemographic data, health care seeking behaviour, life style, facilitators and barriers to medication adherence. Results: Stroke survivors [n=240; mean age 58.64 ±10.96 years); 25.4% females; post-stroke period of 6.65±3.36 months] were interviewed. Patients with diabetes, hypertension and dyslipidaemia constituted 64.2%, 88.8% and 96.7% and optimal control was achieved in 26%, 36.2% and 72.9% respectively. Overall medication adherence was 43.8% (n=240). Adherence to antiplatelet was 62.24% (n=196). Medication adherence was 34.4% (n=134), 52.6% (n=190) and 56.7% (n=224) for antidiabetics, antihypertensives and statins respectively and was associated with risk factor control (Diabetes: Odds Ratio(OR)=4.85;95% Confidence Interval(CI) 2.12-11.08, Hypertension: OR=3.42; 95% CI 1.83-6.4, Dyslipidaemia: OR=3.88;95% CI 1.96-7.69). Having daily routines (OR=2.82;95% CI 1.52-5.25), perceived need of medication (OR= 2.33;95% CI 1.04-5.2) and perceived poor state of health (OR= 3.09; 95% CI 1.44-6.62) as facilitators. Memory problem (OR 0.32; 95% CI 0.51-0.66), experiencing side effects (OR 0.24; 95% CI 0.11-0.53) and belonging to below poverty line (OR 0.46; 95% CI 0.24-0.91) were barriers to medication adherence. Conclusion: Establishing daily routines, periodic reminders, and financial supports to buy medicines and patient education can enhance medication adherence to prevent future strokes.

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Abstract TP147: Prior Stroke Predicts Posttraumatic Stress Disorder and Depression in a Multi-ethnic Cohort of Stroke Survivors

Stroke ◽

10.1161/str.47.suppl_1.tp147 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Emily Goldmann ◽

Nina S Parikh ◽

Bernadette Boden-Albala

Keyword(s):

Mental Health ◽

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Recurrent Stroke ◽

Stroke Survivors ◽

Vascular Events ◽

Previous Stroke ◽

Prior Stroke

Posttraumatic stress disorder (PTSD) and depression are common after stroke and associated with poor outcomes in stroke survivors. Although prior traumatic event experience has been linked to elevated risk of PTSD from a subsequent event, few studies have examined the influence of prior stroke experience on mental health conditions following a subsequent stroke. We hypothesized that prior stroke/TIA experience would be associated with PTSD and depression independently of PTSD following stroke. As part of the Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) trial, a multi-ethnic group of mild/moderate stroke/TIA patients were enrolled in a behavioral intervention to reduce vascular risk. Symptoms of partial or full PTSD and depression were assessed in a six month follow-up survey in 134 patients using the PTSD Checklist and Center for Epidemiologic Studies - Depression scale (CES-D), respectively. PTSD was defined as meeting any DSM-IV criterion B-D, and depression as those with CES-D scores ≥ 8. Patients were categorized as having: 1) no depression or PTSD, 2) depression only, or 3) PTSD (with or without depression). Chi-square tests and multinomial logistic regression were used to examine the association between prior stroke/TIA experience and depression/PTSD. One-third (33.1%) of patients had experienced a prior stroke or TIA. At follow-up, 9.0% and 34.3% of patients met criteria for PTSD and depression without PTSD, respectively. Patients with prior stroke/TIA had 3.6 times greater odds of developing PTSD from the index stroke (95% CI: 1.0-13.3) and 2.7 times the odds of depression only (95% CI: 1.2-6.3) after controlling for age and race/ethnicity. Stroke/TIA patients who had experienced a previous stroke/TIA had significantly greater odds of developing not only PTSD but also depression than those who had not had a previous stroke/TIA. Given the high rate of recurrent stroke and the negative mental health consequences highlighted in this study, interventions that focus on prevention of recurrent stroke are crucial for promoting both physical and psychological well-being among stroke survivors.

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Improving medication adherence in stroke survivors: Mediators and moderators of treatment effects.

Health Psychology ◽

10.1037/hea0000082 ◽

2014 ◽

Vol 33 (10) ◽

pp. 1241-1250 ◽

Cited By ~ 22

Author(s):

Ronan E. O'Carroll ◽

Julie A. Chambers ◽

Martin Dennis ◽

Cathie Sudlow ◽

Marie Johnston

Keyword(s):

Medication Adherence ◽

Treatment Effects ◽

Stroke Survivors

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Improving medication adherence in stroke survivors: the intervention development process

BMC Health Services Research ◽

10.1186/s12913-018-3572-1 ◽

2018 ◽

Vol 18 (1) ◽

Author(s):

Elise Crayton ◽

Alison J Wright ◽

Mark Ashworth

Keyword(s):

Medication Adherence ◽

Development Process ◽

Intervention Development ◽

Stroke Survivors

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Facilitators and barriers to medication adherence among stroke survivors in India

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2021.03.019 ◽

2021 ◽

Vol 88 ◽

pp. 185-190

Author(s):

S.D. Shani ◽

P.N. Sylaja ◽

P. Sankara Sarma ◽

V. Raman Kutty

Keyword(s):

Medication Adherence ◽

Stroke Survivors ◽

Facilitators And Barriers

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MORe PREcISE: A Multicenter Prospective Cohort of Patient Reported Outcome Measures in Stroke

10.21203/rs.3.rs-832600/v1 ◽

2021 ◽

Author(s):

Amber E Corrigan ◽

Ben Carter ◽

Alexander Smith ◽

Anna Pennington ◽

Jonathan Hewitt

Keyword(s):

Mental Health ◽

Outcome Measures ◽

Prospective Cohort ◽

Health Conditions ◽

Stroke Survivors ◽

Ph Domain ◽

Post Stroke ◽

Previous Stroke ◽

Patient Reported ◽

Multicenter Prospective Cohort

Abstract Background and Purpose: The use of patient reported outcomes measures (PROMs) may offer utility and provide outcome measures that are important for stroke survivors. This study used a stroke specific PROM, which contains Mental health (MH) and Physical Health (PH). The primary aim of this study was to assess the association between the MH and PH measures following a stroke and preexisting health conditions. Methods: A multicenter prospective cohort study at 19 hospital sites across England and Wales during 2019 was conducted. Prevalence of morbidity within PROMs was estimated with 95% confidence intervals (95% CI). The association between each PROM domain and demographic and health conditions were calculated using a multilevel multivariable linear model fitting the adjusted mean difference (aMD). Results: PROM morbidity was high post stroke; 93.2% of the participants reported combined post stroke PROM morbidity. The MH domain was associated with pre-existing: diabetes, previous stroke, age, and sex. The PH domain was found to be associated with gender (female) and previous stroke, Conclusions: Stroke survivors ubiquitously suffer morbidity. Risk factors associated with worsening MH and PH morbidity have implications in clinical management as they offer an opportunity to intervene, particularly to prevent long term mental health. PROMs provide useful outcome measure that matter to stroke survivors.

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Factors Influencing 1-Year Medication Adherence of Korean Ischemic Stroke Survivors

International Journal of Behavioral Medicine ◽

10.1007/s12529-020-09854-z ◽

2020 ◽

Vol 27 (2) ◽

pp. 225-234

Author(s):

Gye-Gyoung Kim ◽

Duck-Hee Chae ◽

Man-Seok Park ◽

Sung-Hee Yoo

Keyword(s):

Ischemic Stroke ◽

Medication Adherence ◽

Stroke Survivors ◽

Factors Influencing

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