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http://dx.doi.org/10.5393/JAMCH.2015.40.1.009

Predictors of Persistence and Adherence with Secondary Preventive Medication in Stroke Patients  

Kim, Young Taek (Division of Infectious Disease Control, Centers for Infectious Disease Control, Korea Centers for Disease Control and Prevention)
Park, Ki Soo (Department of Preventive Medicine and Institute of Health Sciences, School of Medicine, Gyeongsang National University)
Bae, Sang-Geun (Department of Preventive Medicine, School of Medicine, Kyungpook National University)
Publication Information
Journal of agricultural medicine and community health / v.40, no.1, 2015 , pp. 9-20 More about this Journal
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.
Keywords
Stroke; Persistence; Adherence; Belief; Depression;
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Times Cited By KSCI : 5  (Citation Analysis)
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