Adherence to Treatment in Stroke Patients

Abstract

Background: Compliance with medication in patients who have suffered stroke is usually not-optimal. This study aims to measure the level of compliance with the treatment and to identify socio-demographic, clinical, and subjective factors related to the long-term compliance of stroke patients with their treatment. Methods: 140 patients (66.4% males) suffered an ischemic stroke at least six months old, participated in the survey. Compliance was measured using the Medication Adherence Report Scale and the quality of life by the Stroke Specific Quality of Life questionnaire. Furthermore, the Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire on perceptions about the disease were assessed. The doctor–patient relationship was assessed by the Common-Sense Model of Self-Regulation questionnaire and the family support was assessed by the FSS scale. Univariate and multivariate analysis was employed to identify the significant factors affecting compliance in these stroke patients. Results: In 68.6% of patients the compliance was classified as optimal, in 25.7% as partial and as poor in 5.7%; the last two categories were treated as sub-optimal compliance in multivariate analysis. The high compliance was related to patient’s mental state (OR:3.94 95% CI: 1.84–4.46), the perception medication necessity (OR:1.26 95% CI: 1.01–1.56), and the doctor–patient communication (OR:1.76 95% CI: 1.15–2.70). Men showed a lower compliance than women, as well as increased concerns about taking medication (OR: 0.83, 95% CI: 0.69–0.99). Paradoxically, the work /productivity related quality of life was inversely associated with compliance (OR (95% CI): 0.44 (0.23 to 0.82)). Conclusions: The perception of medication necessity and the doctor–patient communication are manageable factors associated with compliance in treating patients who have suffered stroke. In addition, rehabilitation and return to work programs should consider these factors when providing support to those persons.

Implementing of an Educational Program on Patients' Knowledge and Self-Efficacy Regarding Recurrent Cerebrovascular Stroke

“…The result of the present study revealed that there is significant correlation between total adherence scores and total self-efficacy score at post phase. Cheiloudaki & Alexopoulos, (2019) supported these findings showed significant correlation between adherance with therapies and their total self-efficacy score at post phase. Wolf et al, (2017), also found that there is a significant correlation between their adherence with therapies and stroke self-efficacy score.…”

Evaluation of Respiratory Muscular Strength Compared to Predicted Values in Patients with Stroke

“…In addition, it can be explained as a vascular alteration that acutely or intermittently weakens blood flow in the brain, caused by arterial obstruction (ischemic stroke) or its rupture (hemorrhagic stroke) [3]. The clinical signs are directly related to the location and extent where the injury occurred [4].…”

Adherence and barriers in e‐health self‐control training for enhancing childhood multidisciplinary obesity treatment

“…The Barriers-to-Treatment Model (1997) is one of the few comprehensive frameworks that can be used to detect both relevant context determinants of adherence, additionally to individual characteristics. This model is still valid today, because evidence points out the importance of life events (Martinez et al, 2018), support of the close environment (Cheiloudaki & Alexopoulos, 2019;Cook, Schmiege, Bradley-Springer, Starr, & Carrington, 2018), and relevance of beliefs, attitudes, self-efficacy, and motivation (Cook et al, 2018;Matsuzawa et al, 2019). When barriers add up, treatment gains are becoming too limited in comparison to the effort, which might lead to nonadherence because of (a) practical obstacles (e.g., time constraints), (b) treatment demands (e.g., frequency of sessions), (c) perceived relevance issues (e.g., doubts on usefulness), (d) problems in the therapeutic relationship (e.g., limited contact), and (e) stressful events (e.g., parental divorce; .…”

“…Adherence is a crucial parameter of treatment success, considering there is evidence for a direct association between high adherence and better clinical outcomes (Candler et al, 2018;Matsuzawa et al, 2019). It is recognized as a general threat in several nonpharmacological chronic disease interventions (Cheiloudaki & Alexopoulos, 2019;Dunbar-Jacob & Mortimer-Stephens, 2001).…”