Adherence to medication in stroke survivors dependent on caregivers

Simoni, Anna De; Mant, Jonathan; Sutton, Stephen

doi:10.3399/bjgp15x687589

Cited by 12 publications

(17 citation statements)

References 17 publications

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“…This may explain the lower adherence rates in observational studies in mixed populations as compared with our study, which included only patients with stroke. Another issue that should be considered in adherence studies on patients with stroke is family involvement (34). Family involvement in medication management should be investigated, especially in collectivist cultures such as in Turkey.…”

Section: Discussionmentioning

confidence: 99%

“…Drug adherence was poorer in patients receiving their drugs with the help of other people (family members) compared with selfusers. There is a knowledge gap in the stroke literature about factors that influence adherence in survivors of stroke with severe disability and the role of their caregivers in patients' adherence (34,38). Moreover, other variables such as patients' characteristics (age, education, drug knowledge score, anxiety and depression, MMSE, mRS, and Barthel) and caregiver characteristics and continuity of the same caregiver may impact adherence.…”

Section: Discussionmentioning

confidence: 99%

“…This factor was also found to be a predictor of adherence. Causing fear and frustration, experiencing adverse effects may result in non-adherence (34).…”

Section: Discussionmentioning

confidence: 99%

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Determination of Factors that Impact Adherence to Warfarin in Patients with Stroke

Tülek¹,

Dünya²,

Çiftçioğlu³

et al. 2019

tnd

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Objective: Oral anticoagulants are the mainstay in the secondary prevention of stroke. Adherence to drug is an important issue in preventing stroke. The aim of this study was to determine the adherence of patients with stroke to warfarin (anticoagulant agent) and to investigate the factors that may impact adherence. Materials and Methods: This descriptive cross-sectional study was conducted on patients admitted to an outpatient neurology clinic of a tertiary hospital in Istanbul. A total of 99 patients with stroke who were under warfarin treatment for at least 6 months prior to the study were enrolled in the study. Patients were assessed in terms of sociodemographic characteristics, adherence to and knowledge regarding the drug, anxiety and depression, mental and functional state and quality of life using validated scales. Results: The mean adherence score of the patients was 3.3±1.1 (0-4). The reported adherence rates were not considered as low in our sample given that 42% had poor knowledge. Significant negative correlations were determined between drug adherence and age, number of risk factors, and duration of anticoagulant use (r=-0.39, r=-0.33, r=-0.52, p<0.001, respectively). The mean drug adherence scores were lower in patients who had experienced drug-related adverse effects compared with those that did not (p=0.018). Significant correlations were found between the adherence scale and all other variables (p<0.05). Multiple linear regression analysis revealed that drug adherence was predicted by experiencing adverse effects, knowledge regarding the drug, and depression. Conclusion: Knowledge regarding the use of warfarin was inadequate in our patients, whereas adherence was reported not to be inadequate. The most influential factors that may impact adherence were adverse effects, knowledge, and depression. Healthcare professionals should be aware of patients who have risk factors for non-adherence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Determination of Factors that Impact Adherence to Warfarin in Patients with Stroke

Tülek¹,

Dünya²,

Çiftçioğlu³

et al. 2019

tnd

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“… 13 As patients’ dependency on caregivers for medicine taking increases, caregivers’ factors also become relevant in determining patients’ adherence. 10 Indeed, a recent interview study by the authors 14 highlighted the importance of caregivers in adherence to secondary prevention medications. Findings from another study suggest that among patients with cardiovascular disease, those with a caregiver were more likely to be adherent to medications.…”

Section: Introductionmentioning

confidence: 99%

“… 15 There is a need to investigate adherence to secondary prevention medications after stroke avoiding self-presentational and reactivity biases, including patients with severe disabilities and caregivers factors. 10 Online health forums are accessible 24/7 in the form of asynchronous communication that is convenient to the user. This medium offers anonymity and encourages honesty.…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to adherence to secondary stroke prevention medications after stroke: analysis of survivors and caregivers views from an online stroke forum

et al. 2017

Self Cite

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ObjectiveTo identify barriers and facilitators of medication adherence in patients with stroke along with their caregivers.DesignQualitative thematic analysis of posts about secondary prevention medications, informed by Perceptions and Practicalities Approach.SettingPosts written by the UK stroke survivors and their family members taking part in the online forum of the Stroke Association, between 2004 and 2011.Participants84 participants: 49 stroke survivors, 33 caregivers, 2 not stated, identified using the keywords ‘taking medication’, ‘pills’, ‘size’, ‘side-effects’, ‘routine’, ‘blister’ as well as secondary prevention medication terms.ResultsPerceptions reducing the motivation to adhere included dealing with medication side effects, questioning doctors’ prescribing practices and negative publicity about medications, especially in regard to statins. Caregivers faced difficulties with ensuring medications were taken while respecting the patient’s decisions not to take tablets. They struggled in their role as advocates of patient’s needs with healthcare professionals. Not experiencing side effects, attributing importance to medications, positive personal experiences of taking tablets and obtaining modification of treatment to manage side effects were facilitators of adherence. Key practical barriers included difficulties with swallowing tablets, dealing with the burden of treatment and drug cost. Using medication storage devices, following routines and getting help with medications from caregivers were important facilitators of adherence.ConclusionsAn online stroke forum is a novel and valuable resource to investigate use of secondary prevention medications. Analysis of this forum highlighted significant barriers and facilitators of medication adherence faced by stroke survivors and their caregivers. Addressing perceptual and practical barriers highlighted here can inform the development of future interventions aimed at improving adherence to secondary prevention medication after stroke.

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Emotional adjustment post-stroke: A qualitative study of an online stroke community

Smith

Jones

Gracey

et al. 2019

Neuropsychological Rehabilitation

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Understanding of emotional adjustment after stroke is limited. Under one-third of stroke survivors reporting emotional problems receive support. The aim of this study was to explore the process of emotional adjustment post-stroke and investigate the role played by participation in an online stroke community. We applied thematic analysis to 124 relevant posts within 114 discussion threads, written by 39 survivors and 29 carers. The contribution of online community engagement to emotional adjustment was explored using the Social Support Behaviour Code.Stroke survivors share common experiences of emotional adjustment and may not necessarily reach complete acceptance. Positive and negative trajectories of emotional adjustment were identified.Survivors progressed along, or moved between, positive and negative pathways not in a time-dependent manner but in response to 'trigger events', such as physical setbacks or anti-depressant treatment, which may occur at any chronological time. An adapted version of Suhr's 1990 Social Support Behaviour Code showed that support provided through the online community took many forms, including advice, teaching, empathy and normalisation of concerns. Participation in the stroke community was itself deemed to be a positive 'trigger event'.

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Adherence to medication in stroke survivors dependent on caregivers

Cited by 12 publications

References 17 publications

Determination of Factors that Impact Adherence to Warfarin in Patients with Stroke

Determination of Factors that Impact Adherence to Warfarin in Patients with Stroke

Barriers and facilitators to adherence to secondary stroke prevention medications after stroke: analysis of survivors and caregivers views from an online stroke forum

Emotional adjustment post-stroke: A qualitative study of an online stroke community

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