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Factors Influencing 1-Year Medication Adherence of Korean Ischemic Stroke Survivors

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Abstract

Background

Medication adherence is important for secondary stroke prevention. However, suboptimal adherence to medication among patients after stroke or transient ischemic attack is reportedly 30.9%. We assessed medication adherence of Korean stroke survivors within 1 year of acute ischemic stroke and identified factors that influence adherence.

Methods

We consecutively enrolled ischemic stroke survivors who visited the Department of Neurology of a university hospital from March 9 to June 15, 2016. Data were collected by face-to-face interviews using a structured questionnaire which assessed general characteristics, clinical characteristics, medication beliefs, social support, and depression. Medication adherence was measured using the 8-item Morisky Medication Adherence Scale. Multiple logistic regression was used to identify factors independently associated with medication adherence.

Results

Of the total 250 participants, 183 (73%) were in the optimal adherence group. Age (p = 0.035), smoking (p = 0.020), number of prescribed medicines (p = 0.037), frequency of daily doses (p = 0.040), and beliefs about medication (p < 0.001) were associated with medication adherence. Optimal medication adherence was associated with being a non-smoker (OR, 3.19; 95% CI, 1.29–7.87; p = 0.012), more prescribed medicines (OR, 1.27; 95% CI, 1.05–1.54; p = 0.014), less frequency of daily doses (OR, 0.37; 95% CI, 0.18–0.79; p = 0.010), and stronger beliefs about medication (OR, 1.09; 95% CI, 1.03–1.15; p = 0.004).

Conclusion

To improve medication adherence of stroke survivors, post-stroke care should focus on bolstering patients’ belief in the necessity of medication and encouraging lifestyle modifications, such as quitting smoking, as well as prescribing medicine with simple regimens.

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Acknowledgments

The use of the ⓒMMAS is protected by US copyright laws. Permission for use is required. A license agreement is available from Donald E. Morisky, MMAS Research LLC 14725 NE 20th St. Bellevue WA 98007 or from dmorisky@gmail.com.

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Authors and Affiliations

  1. College of Nursing, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea

    Gye-Gyoung Kim, Duck-Hee Chae & Sung-Hee Yoo

  2. Department of Neurology, Medical school, Chonnam National University, Gwangju, Republic of Korea

    Man-Seok Park

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  1. Gye-Gyoung Kim
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Correspondence to Sung-Hee Yoo.

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Kim, GG., Chae, DH., Park, MS. et al. Factors Influencing 1-Year Medication Adherence of Korean Ischemic Stroke Survivors. Int.J. Behav. Med. 27, 225–234 (2020). https://doi.org/10.1007/s12529-020-09854-z

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