Predictors of Adherence to Secondary Preventive Medication in Stroke Patients

O’Carroll, Ronan; Whittaker, Jennifer; Hamilton, Barbara; Johnston, Marie; Sudlow, Cathie; Dennis, Martin

doi:10.1007/s12160-010-9257-6

Cited by 93 publications

(137 citation statements)

References 19 publications

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“…It is shown that negative mood side effects, specifically depression, irritability and increased levels of anxiety are most commonly cited reasons for women discontinue using OCPs. A study from UK showed that the incidence of depression and mood changes among the pill users was about 30% (22). These results are compatible with ours.…”

Section: Discussionsupporting

confidence: 92%

Continuation and Discontinuation Reasons of LD Contraceptives among Iranian Women

Kamalifard¹,

Malakouti²,

Pezeshki³

et al. 2014

IJWHR

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Section: Discussionsupporting

confidence: 92%

Continuation and Discontinuation Reasons of LD Contraceptives among Iranian Women

Kamalifard¹,

Malakouti²,

Pezeshki³

et al. 2014

IJWHR

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“…8 , 14 , [27][28][29] This analysis adds to the literature by showing that in comparison with other possible barriers to medication adherence, concerns about medications, such as becoming dependent on them or worrying about their long-term consequences, have the strongest association with non-adherence and hence represent a key barrier to overcoming non-adherence, at least in our group of stroke and TIA survivors.…”

Section: Discussionmentioning

confidence: 69%

Key Barriers to Medication Adherence in Survivors of Strokes and Transient Ischemic Attacks

et al. 2013

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BACKGROUND: Even though medications can greatly reduce the risk of recurrent stroke, medication adherence is suboptimal in stroke survivors. OBJECTIVE: To identify key barriers to medication adherence in a predominantly low-income, minority group of stroke and transient ischemic attack (TIA) survivors. DESIGN: Cross-sectional study. PARTICIPANTS: Six hundred stroke or TIA survivors, age ≥ 40 years old, recruited from underserved communities in New York City. MAIN MEASURES: Medication adherence was measured using the 8-item Morisky Medication Adherence Questionnaire. Potential barriers to adherence were assessed using validated instruments. Logistic regression was used to test which barriers were independently associated with adherence. Models were additionally controlled for age, race/ethnicity, income, and comorbidity. KEY RESULTS: Forty percent of participants had poor self-reported medication adherence. In unadjusted analyses, compared to adherent participants, nonadherent participants had increased concerns about medications (26 % versus 7 %, p<0.001), low trust in their personal doctor (42 % versus 29 %, p=0.001), problems communicating with their doctor due to language (19 % versus 12 %, p = 0.02), perceived discrimination from the health system (42 % versus 22 %, p<0.001), difficulty accessing health care (16 % versus 8 %, p=0.002), and inadequate continuity of care (27 % versus 20 %, p=0.05). In the fully adjusted model, only increased concerns about medications [OR 5.02 (95 % CI 2.76, 9.11); p<0.001] and perceived discrimination [OR 1.85 (95 % CI 1.18, 2.90); p= 0.008] remained significant barriers. CONCLUSIONS: Increased concerns about medications (related to worry, disruption, long-term effects, and medication dependence) and perceived discrimination were the most important barriers to medication adherence in this group. Interventions that reduce medication concerns have the greatest potential to improve medication adherence in low-income stroke/ TIA survivors.KEY WORDS: medication adherence; stroke; transient ischemic attack; barriers.

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“…In comparison, the cardiovascular group (ACS/Stroke/Coronary Artery Bypass Surgery/Heart Failure) showed no correlation between necessity beliefs and adherence. Patients with more severe cardiovascular disease, such as those who have had a stroke often express concerns that they are prescribed too many medicines and medicines can give bad side effects without any symptomatic benefit or making them feel any better [60,119]. It appears that the relationship between medication adherence and concern beliefs is stronger than the relationship with necessity beliefs in patients with cardiovascular disease (ACS/Stroke/Coronary Artery Bypass Surgery/Heart Failure).…”

Section: Discussionmentioning

confidence: 99%

The necessity–concerns framework predicts adherence to medication in multiple illness conditions: A meta-analysis

Foot

Caze

Gujral

et al. 2016

Patient Education and Counseling

132

104

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2 Highlights We investigated the relationship between medication beliefs and adherence  Necessity beliefs were significantly positively correlated with adherence  Concern beliefs were significantly negatively correlated with adherence  Necessity effect size was different in asthma and cardiovascular group 3 Abstract ObjectiveThis meta-analysis investigated whether beliefs in the necessity and concerns of medicine and the necessity-concerns differential are correlated with medication adherence on a population level and in different conditions. MethodsAn electronic search of Web of Science, EMBASE, PubMed and CINAHL was conducted for manuscripts utilising the Beliefs about Medicines Questionnaire and comparing it to any measure of medication adherence. Studies were pooled using the random-effects model to produce a mean overall effect size correlation. Studies were stratified for condition, adherence measure, power and study design. ResultsNinety-four papers were included in the meta-analysis. The overall effect size(r) for necessity, concerns, and necessity-concerns differential was 0.17, -0.18 and 0.24 respectively and these were all significant (p<0.0001). Effect size for necessity was stronger in asthma and weaker in the cardiovascular group compared to the overall effect size. ConclusionNecessity and concerns beliefs and the necessity-concerns differential were correlated with medication adherence on a population level and across the majority of included conditions. The effect sizes were mostly small with a magnitude comparable to other predictors of adherence. Practice implicationsThis meta-analysis suggests that necessity and concern beliefs about medicines are one important factor to consider when understanding reasons for non-adherence.

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Predictors of Adherence to Secondary Preventive Medication in Stroke Patients

Abstract: Interventions to improve adherence should target patients' beliefs about their medication.

Cited by 93 publications

References 19 publications

Continuation and Discontinuation Reasons of LD Contraceptives among Iranian Women

Continuation and Discontinuation Reasons of LD Contraceptives among Iranian Women

Key Barriers to Medication Adherence in Survivors of Strokes and Transient Ischemic Attacks

The necessity–concerns framework predicts adherence to medication in multiple illness conditions: A meta-analysis

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