Predictors of Adherence to Secondary Preventive Medication in Stroke Patients

Abstract

Objective: The purpose of this study is to identify factors which predict adherence in stroke survivors. Design : This is a longitudinal study where 180 stroke survivors were assessed 1 year after their first ischaemic stroke. The relationship between adherence and illness and medication beliefs was tested at baseline (time 1) and again 5-6 weeks later (time 2). Main Outcome Measures : The main outcome measures used in this study are Medication Adherence Report Scale and urinary salicylate levels. Results : Four variables predicted time 1 poor adherence: (1) younger age, (2) increased specific concerns about medications, (3) reduced cognitive functioning and (4) low perceived benefit of medication. Three out of these four variables were again predictive of time 2 adherence and accounted for 24% of the variance: (1) younger age, (2) increased specific concerns about medications and (3) low perceived benefit of medication. The urinary salicylate assay failed to differentiate between patients taking and not taking aspirin. Conclusion : Interventions to improve adherence should target patients' beliefs about their medication.