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

Kronish, Ian M.; Diefenbach, Michael A.; Edmondson, Donald; Phillips, L. Alison; Fei, Kezhen; Horowitz, Carol R.

doi:10.1007/s11606-012-2308-x

Cited by 75 publications

(72 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In previous studies, limited access to medication [3,23,24,28] and inadequate healthcare system where reported as barriers for medication adherence affecting the relationship between patients and healthcare professionals. Since the French healthcare system allows free access to medication, it could explain why these issues were not reported here and probably do not constitute a major barrier for treatment compliance in French stroke survivors.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the specific issue of medication adherence, Leventhal's self-regulatory model of illness behavior was highly relevant [3,22]. In previous studies, this model supported the relationship between medication adherence and beliefs and expectations regarding treatments [8,12,18,23,24]. In addition to collecting information from patients and caregivers, it seemed relevant to collect experiences from healthcare professionals as they play a significant role in the patients' care management [25].…”

Section: Introductionmentioning

confidence: 90%

“…Furthermore, beliefs differ from one country to another, based on healthcare systems and access to treatment [3,24,28]. To date, no French study has investigated medication beliefs in patients, caregivers and healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Barriers and Facilitators for Medication Adherence in Stroke Patients: A Qualitative Study Conducted in French Neurological Rehabilitation Units

Bauler¹,

Jacquin-Courtois²,

Haesebaert³

et al. 2014

Eur Neurol

View full text Add to dashboard Cite

Objective: To describe the perceptions of French patients, caregivers and healthcare professionals on stroke and secondary preventive medications. Method: A qualitative study was conducted, based on four predetermined topics: stroke, secondary prevention medications, patient's experience, relationship between patient/caregiver and healthcare team. Results: Twenty-six interviews were conducted. Difficulties in taking medications, lack of knowledge on stroke and medication benefits, fear of overmedication were identified as barriers for adherence in patients. Doubts about generic drugs were expressed by caregivers. Healthcare professionals reported lack of knowledge and absence of clinical symptoms as barriers. On the other hand, support from caregivers and healthcare professional support is essential for compliance in all participants. Patients and caregivers expressed that fear of recurrence was a facilitator for treatment compliance. Conclusion: This study highlights the barriers and facilitators for stroke treatment adherence and underlines the similarities and differences between the perceptions of patients, caregivers and healthcare professionals. These results must be integrated into the future French educational programs to improve medication adherence.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

See 1 more Smart Citation

Barriers and Facilitators for Medication Adherence in Stroke Patients: A Qualitative Study Conducted in French Neurological Rehabilitation Units

Bauler¹,

Jacquin-Courtois²,

Haesebaert³

et al. 2014

Eur Neurol

View full text Add to dashboard Cite

show abstract

“…For example, 70% of stroke survivors have hypertension [9], 77% have impaired glucose tolerance or type 2 diabetes mellitus [10], and 18 to 44% are obese [11]. In addition, individuals with stroke are not physically active, 40% report nonadherence to medication regimens [12], and many have unhealthy dietary patterns [13].…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis on Self-Management for Improving Risk Factor Control in Stroke Patients

2016

View full text Add to dashboard Cite

Purpose-The aim of this review was to describe the self-management interventions used to improve risk factor control in stroke patients, and quantitatively assess their effects on: 1) overall risk factor control from lifestyle behaviour (i.e. physical activity, diet and nutrition, stress management, smoking, alcohol, and medication adherence), and medical risk factors (i.e. blood pressure, cholesterol, blood glucose); and 2) individual risk factors (e.g. physical activity, blood pressure, cholesterol).Methods-We systematically searched the PubMed, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews databases to September 2015 to identify relevant randomized controlled trials investigating self-management to improve stroke risk factors. The selfmanagement interventions were qualitatively described, and the data included in meta-analyses.Results-Fourteen studies were included for review. The model estimating an effect averaged across all stroke risk factors was not significant, but became significant when four low quality studies were removed (SMD = 0.10 [95% CI = 0.02 to 0.17], I 2 = 0%, p=0.01). Subgroup analyses revealed a significant effect of self-management interventions on lifestyle behaviour risk factors (SMD = 0.15 [95% CI = 0.04 to 0.25], I 2 = 0%, p=0.007) but not medical risk factors. Medication adherence was the only individual risk factor that self-management interventions significantly improved (SMD = 0.31 [95% CI = 0.07 to 0.56], I 2 = 0%, p=0.01).Conclusions-Self-management interventions appear to be effective at improving overall risk factor control, however, more high quality research is needed to corroborate this observation. SelfCorresponding author: Janice J. Eng, PhD, BSc(PT/OT), Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Tel: 604-714-4108; Fax: 604-714-4168; janice.eng@ubc.ca. Compliance with Ethical StandardsConflict of Interest: BMS declares that he has no conflict of interest. AJK declares that she has no conflict of interest. JJE declares that she has no conflict of interest. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent: Informed consent was obtained from all individual participants included in the study.

show abstract

“…Previous studies have shown that poor adherence was associated with cognitive dysfunction, a high number of treatments, higher medication copayment and a prolonged time between symptoms and neurological evaluation at acute phase. Some behavioral factors are also to consider, such as concerns about medication (fear of side effects or dependency), complexity of the treatment, lack of perceived benefit for these treatments and perceived discrimination from the healthcare system [24, 31, 32]. …”

Section: Discussionmentioning

confidence: 99%

Secondary Prevention Three and Six Years after Stroke Using the French National Insurance Healthcare System Database

et al. 2018

View full text Add to dashboard Cite

Background: Secondary prevention is inadequate in the first 2 years after stroke but what happens after that is less documented. The aim of this study was to assess the use and the adherence to preventive drugs 3 and 6 years after experiencing a transient ischemic attack (TIA) or an ischemic stroke (IS). Methods: The population study was from the AVC69 cohort (IS or TIA admitted in an emergency or stroke unit in the Rhône area, France, for an IS or a TIA during a 7-month period). Medication use was defined as ≥1 purchase during the studied year and adherence as Continuous Measure of Medication Acquisition ≥0.8 using the French medical insurance health care funding database. Results: The study population consisted of 210 patients at 3 years and 163 patients at 6 years. Medication use at 3 and 6 years was, respectively, 80.9 and 79.8% for antithrombotics, 69.1 and 66.3% for antihypertensives, 60.5 and 55.2% for statins and 48.6 and 46.6% for optimal treatment defined as the treatment achieved by the use of the 3 drugs. Adherence to each class was good at 3 years and tends to decrease at 6 years. Conclusions: More than one patient out of 2 do not use the optimal preventive treatment.

show abstract

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

Cited by 75 publications

References 42 publications

Barriers and Facilitators for Medication Adherence in Stroke Patients: A Qualitative Study Conducted in French Neurological Rehabilitation Units

Barriers and Facilitators for Medication Adherence in Stroke Patients: A Qualitative Study Conducted in French Neurological Rehabilitation Units

A Systematic Review and Meta-Analysis on Self-Management for Improving Risk Factor Control in Stroke Patients

Secondary Prevention Three and Six Years after Stroke Using the French National Insurance Healthcare System Database

Contact Info

Product

Resources

About