Prestroke Medication Adherence and its Clinical Significance in
Patients With Ischemic Stroke: Single Hospital-Based Study

J Korean Neurol Assoc > Volume 28(4); 2010 > Article

Journal of the Korean Neurological Association 2010;28(4): 270-276.

허혈뇌졸중 환자들의 발병 전 약물 순응과 임상적 의의: 일개병원기반 조사

박태환, 장명숙 a 양미화 a 한문구 a 배희준 a

서울의료원 신경과, 분당서울대학교병원 신경과 뇌졸중센터 a

Prestroke Medication Adherence and its Clinical Significance in Patients With Ischemic Stroke: Single Hospital-Based Study

Tai Hwan Park,

Department of Neurology, Seoul Medical Center, Seoul, Korea Department of Neurology a , Stroke Center, Seoul National University Bundang Hospital a , Seongnam, Korea

Abstract

Background: Medication adherence (MA) is poor among patients with chronic illnesses, such as those involving the risk factors of stroke. However, the impacts of poor MA on the modifiable risk factors of stroke are not well known.
Methods: We evaluated the MA for the control of hypertension, diabetes, hyperlipidemia, and previous ischemic stroke among consecutive patients with ischemic stroke within 7?days of symptom onset. Nonadherence was defined as taking doctor?prescribed medications for less than 3?weeks during the previous month. Demographic data, risk factor profile, stroke mechanism, and baseline score on the National Institutes of Health Stroke Scale (NIHSS) were compared among patients with nonadherence and those without.
Results: Among 1133 patients with at least one medicated risk factor, the rates of nonadherence in hypertension, diabetes, hyperlipidemia, and previous ischemic stroke were 18.5%, 15.3%, 30.3%, and 28.1%, respectively. Overall, 27.4% of patients with more than one risk factor presented nonadherence, with a predilection toward being male (male, 63.9% vs. female, 56.1%, p=0.02) and younger (mean age 64.9?years vs. 66.4?years, p=0.01). Stroke severity according to MA did not differ using either crude analysis (NIHSS score: 5.5±5.9 vs. 5.4±5.5, p=0.71) or multivariable analysis after log transformation. The prevalence of nonadherence was low for large?artery disease and small?vessel occlusion, and high for cardioembolism.
Conclusions: Prestroke poor MA for the major risk factors was common among patients with chronic illnesses, and was more frequent in younger male patients. Stroke severity was not affected by MA during the month preceding stroke. Key Words: Medication adherence, Stroke