Adherence to Secondary Stroke Prevention Therapies  in Ischemic Stroke Patients at Teaching Hospital in Central Java Indonesia

Karuniawati, Hidayah; Ikawati, Zullies; Gofir, Abdul

doi:10.22159/ajpcr.2017.v10s2.19478

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…Of the 31 studies, 12 focused on CAM usage among patients with stroke, (Lee et al, 2004;Shin et al, 2008;Shaikh et al, 2009;Chang et al, 2011;Liao et al, 2012;Pandian et al, 2012;Ali et al, 2015;Kadir et al, 2015;Chang et al, 2016;Teo et al, 2016;Weng et al, 2016;Yeh et al, 2017), 15 reported medication adherence, (De Schryver et al, 2005;Osterberg and Blaschke, 2005;Arif et al, 2007;Khan et al, 2010;Bushnell et al, 2011;Chambers et al, 2011;Kronish et al, 2013;Sjölander et al, 2013;Jiang et al, 2017;Kim et al, 2017;Wei et al, 2017;Cheiloudaki and Alexopoulos, 2019;Rohde et al, 2019;Han et al, 2020;Saade et al, 2021), and only 4 investigated CAM usage and patients' adherence to stroke medications (Johnson et al, 2012;Karuniawati et al, 2017;Alhawsawi et al, 2020;Kim et al, 2020). The study design and country settings are summarized in Table 2, Table 3, Table 4 to Table 5.…”

Section: Resultsmentioning

confidence: 99%

“…Johnson et al assessed adherence to stroke medication and CAM use and found that 7% of non-adherent patients were using CAM as a treatment for stroke (Johnson et al, 2012). Similarly, Karuniawati et al reported that 29% were non-adherent to their medication regimen and 3.3% of them preferred to use CAM (Karuniawati et al, 2017). This study concluded that patients tended to stop taking their medication after feeling better.…”

Section: Effect Of Complementary Alternative Medicine Usage On Adhere...mentioning

confidence: 99%

“…With regards to the limitations of this work, there seems to be limited evidence on stroke medication non-adherence as a result of CAM usage. Although many studies have reported the reasons for CAM usage among stroke patients, among the 20 studies included in this review, the association between stroke medication adherence and CAM use was only assessed in three studies (Johnson et al, 2012;Karuniawati et al, 2017;Kim et al, 2018).…”

Section: Limitationsmentioning

confidence: 99%

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Use of Complementary and Alternative Medicine and Adherence to Medication Therapy Among Stroke Patients: A Meta-analysis and Systematic Review

et al. 2022

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Purpose: To identify the use patterns of complementary and alternative medicine (CAM) and its impact on medication adherence among patients with stroke.Method: A systematic search through Science Direct, Google Scholar, and PubMed was performed to identify potential studies up to June 2021.The primary outcome was CAM use, and the secondary outcome was medication adherence among patients with stroke. Articles included in the review met the following criteria: 1) patients with stroke ≥18 years old on prescribed medications, and 2) medication adherence reported status. Meta-analyses were conducted to estimate the pooled prevalence of complementary and alternative medicine and adherence in stroke patients using a random-effects model.Results: A total of 1,330 studies were screened, of which 22 were included in the final analysis. The type of studies included were cross-sectional surveys, cohort studies, retrospective studies and prospective survey. The pooled prevalence of CAM usage was at 38% (29–48% CI) and medication non-adherence among stroke patients was at 29% (20–48% CI). The most common reason for inadequate stroke therapy and higher dependence on CAM was the patients’ lack of knowledge and the regimen complexity of the medication. Other factors for medication non-adherence were forgetfulness, side effects, cost, and lack of doctor-patient communication.Conclusion: A low prevalence of CAM usage and non-adherence to medications was observed among patients with stroke. Studies investigating the association between CAM usage and medication adherence among patients with stroke are scarce and future researches are needed to explore the influence of CAM use on stroke medication adherence.

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Section: Resultsmentioning

confidence: 99%

Section: Effect Of Complementary Alternative Medicine Usage On Adhere...mentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Use of Complementary and Alternative Medicine and Adherence to Medication Therapy Among Stroke Patients: A Meta-analysis and Systematic Review

et al. 2022

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“…In other settings, medication beliefs were found to be one of the important modifiable factors associated with intentional (a conscious decision after balancing the pros and cons of a medication) and unintentional (lack of understanding or forgetfulness) non-adherence. [18][19][20][21][22] Medication beliefs in general among patients in Asia 23 and in particular to cardiovascular drugs in Indonesia 21 were reported low. The Necessity-Concern Framework emphasizes that medication beliefs consist of the necessity of drugs based on beliefs about the positive effects and concerns about the adverse consequences of taking a drug.…”

Section: Introductionmentioning

confidence: 99%

Modifiable Factors Associated with Non-adherence to Antihypertensive or Antihyperlipidemic Drugs Are Dissimilar: a Multicenter Study Among Patients with Diabetes in Indonesia

et al. 2020

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BACKGROUND: To develop targeted and tailored interventions for addressing medication non-adherence, it is important to identify underlying factors. OBJECTIVE: To identify factors associated with nonadherence as well as subtypes of non-adherence to antihypertensive or antihyperlipidemic drugs among patients with type 2 diabetes in Indonesia. DESIGN: An observational multicenter cross-sectional survey. PARTICIPANTS: Patients with type 2 diabetes using either antihypertensive or antihyperlipidemic drugs in four regions in Indonesia. MAIN MEASURES: Non-adherence and its subtypes of intentional and unintentional non-adherence were assessed using the Medication Adherence Report Scale. Necessity and concern beliefs were assessed with the Beliefs about Medicines Questionnaire. We applied binary and multinomial logistic regression to assess associations of medication beliefs, sociodemographic factors, and clinical-related factors to non-adherence and report odds ratios (OR) with 95% confidence intervals (CI). KEY RESULTS: Of 571 participating patients (response rate 97%), 45.5% and 52.7% were non-adherent to antihypertensive and antihyperlipidemic drugs, respectively. Older age was associated with non-adherence to antihypertensive drugs (60-69 years) (OR, 5.65; 95% CI, 2.68-11.92), while higher necessity beliefs (OR, 0.92; 95% CI, 0.88-0.95) were associated with less non-adherence. Factors associated with non-adherence to antihyperlipidemic drugs were female gender (OR, 1.84; 95% CI, 1.03-3.27) and higher concern beliefs (OR, 1.10; 95% CI, 1.03-1.18), while higher necessity beliefs (OR, 0.89; 95% CI, 0.83-0.96) were associated with less non-adherence. CONCLUSIONS:The main factors associated with nonadherence to antihypertensive and antihyperlipidemic drugs are modifiable. In general, beliefs about the necessity of the drug are important but for antihyperlipidemic drugs concerns are important as well. Healthcare providers should pay attention to identify and address medication beliefs during patient counselling.

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“…In Indonesia, the prevalence of stroke increased from 7% in 2013 to 10.9% in 2018 and increased with age [5]. Based on the data basis of health research [6], number of patients who have been diagnosed stroke are 2,137,941 patients (12.1%). Stroke patients were mostly found in the age group of 45-54 y, 55-64 y, and 65-74 y [7].…”

Section: Introductionmentioning

confidence: 99%

Prebiotics for Acute Ischemic Stroke

Renamastika

Wahyuningrum

Putri³

et al. 2021

Int J Pharm Pharm Sci

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There is two-way communication between the gut and the brain. The condition of the quality and quantity of microbiota in the gut greatly affects the communication process or commonly known as the microbiota-gut-brain axis. Acute ischemic stroke can affect the quality and quantity of microbiota in the gut, which leads to intestinal dysbiosis. Thus, it might produce an inflammatory response that can change immune homeostatic. This can lead to poor clinical outcomes and neurologic function and an increase in mortality. Dysbiosis is a condition where there are qualitative and quantitative changes in the composition, distribution, and metabolic activity of intestinal microbiota which have a detrimental effect on human health, in other words, there is a decrease in the number of probiotic bacteria in the gut, which provide health benefits. The conditions for a good probiotic are that the probiotics have to be kept alive in the digestive tract to obtain health benefits. The approach taken to keep these bacteria alive is the use of prebiotics. Prebiotics are components of food that cannot be digested by the digestive tract enzymatically. Thus, they are fermented by microbiota in the large intestine to produce metabolites, one of which is short-chain fatty acids (SCFA) as a product of fermentation. SCFA (Short Chain Fatty Acid) or short-chain fatty acids play a neuroprotective role, synthesizing neurotransmitters and modulating the immune system. Therefore, this review explains how stroke affects the quantity and quality of microbiota in the gut in the communication process of the microbiota-gut-brain axis and the role of prebiotics in improving dysbiosis. Hence, it can provide better post-stroke clinical outcomes.

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Adherence to Secondary Stroke Prevention Therapies in Ischemic Stroke Patients at Teaching Hospital in Central Java Indonesia

Cited by 4 publications

References 12 publications

Use of Complementary and Alternative Medicine and Adherence to Medication Therapy Among Stroke Patients: A Meta-analysis and Systematic Review

Use of Complementary and Alternative Medicine and Adherence to Medication Therapy Among Stroke Patients: A Meta-analysis and Systematic Review

Modifiable Factors Associated with Non-adherence to Antihypertensive or Antihyperlipidemic Drugs Are Dissimilar: a Multicenter Study Among Patients with Diabetes in Indonesia

Prebiotics for Acute Ischemic Stroke

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