Improving Adherence to Medication in Stroke Survivors: A Pilot Randomised Controlled Trial

Abstract

Background: Adherence to preventive medication is often poor, and current interventions have had limited success. Purpose: This study was conducted to pilot a randomised controlled trial aimed at increasing adherence to preventive medication in stroke survivors using a brief, personalised intervention. Methods: Sixty-two stroke survivors were randomly allocated to either a two-session intervention aimed at increasing adherence via (a) introducing a plan linked to environmental cues (implementation intentions) to help establish a better medication-taking routine (habit) and (b) eliciting and modifying any mistaken patient beliefs regarding medication/stroke or a control group. Primary outcome was adherence to antihypertensive medication measured objectively over 3 months using an electronic pill bottle. Results: Fifty-eight people used the pill bottle and were analysed as allocated; 54 completed treatment. The intervention resulted in 10 % more doses taken on schedule (intervention, 97 %; control, 87 %; 95 % CI for difference (0.2, 16.2); p = 0.048). Conclusions: A simple, brief intervention increased medication adherence in stroke survivors, over and above any effect of increased patient contact or mere measurement. (http://controlled-trials.com, number ISRCTN38274953.)