RESUMEN
BACKGROUND: Although the optimal use of prescribed medications for stroke survivors is critical for preventing secondary stroke, longitudinal observations of the natural course of medication persistence and adherence in Korean stroke survivors are rare. Furthermore, studies are needed to identify strong predictors influencing medication adherence and to determine whether these predictors change over time. AIMS AND OBJECTIVES: To evaluate the longitudinal medication persistence and adherence at 3 months and 1 year after discharge in all stroke patients and to identify predictors of long-term medication adherence in patients who can self-medicate. DESIGN: A multicentre, prospective, longitudinal descriptive study. METHODS: A total of 600 consecutive ischaemic stroke patients were recruited from three stroke centres across Korea, from 1 September, 2017 to 28 February, 2019. Various factors related to medication adherence suggested by the World Health Organisation were investigated through face-to-face interviews at each centre during hospitalisation. Medication persistence and adherence were assessed at 3 months and 1 year after discharge using the eight-item Morisky Medication Adherence Scale through telephone interviews. RESULTS: Of 537 survivors at 3 months, 526 (98.0%) were persistent and 472 (89.7%) were adherent. Of 493 survivors at 1 year, 477 (96.8%) were persistent and 392 (82.2%) were adherent. Medication belief, income and health literacy were statistically significant predictors of three-month medication adherence, which predicted one-year medication adherence with older age and low income. CONCLUSIONS: Among Korean stroke survivors, three-month and one-year medication persistence and adherence were relatively good. Medication beliefs and three-month medication adherence were important and modifiable factors predicting three-month adherence and one-year adherence, respectively. RELEVANCE TO CLINICAL PRACTICE: To increase long-term adherence to medication, various strategies are needed to improve beliefs about medication, taking into account the patient's age and level of knowledge. These interventions need to be initiated during hospitalisation to form early medication habits after discharge.
Asunto(s)
Isquemia Encefálica , Accidente Cerebrovascular , Humanos , Accidente Cerebrovascular/tratamiento farmacológico , Accidente Cerebrovascular/prevención & control , Isquemia Encefálica/tratamiento farmacológico , Prevención Secundaria , Estudios Longitudinales , Estudios Prospectivos , Cumplimiento de la MedicaciónAsunto(s)
Endocarditis/diagnóstico , Infarto de la Arteria Cerebral Media/diagnóstico , Aneurisma Intracraneal/diagnóstico , Micosis/diagnóstico , Hemorragia Subaracnoidea/diagnóstico , Angiografía Cerebral , Ecocardiografía , Endocarditis/complicaciones , Humanos , Infarto de la Arteria Cerebral Media/etiología , Aneurisma Intracraneal/etiología , Masculino , Persona de Mediana Edad , Micosis/complicaciones , Hemorragia Subaracnoidea/etiología , Tomografía Computarizada por Rayos XAsunto(s)
Mejilla/diagnóstico por imagen , Quistes/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Neuralgia del Trigémino/diagnóstico por imagen , Quistes/etiología , Quistes/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Neuralgia del Trigémino/cirugíaRESUMEN
Atrial fibrillation and cerebral embolism are known to increase the risk of hemorrhagic transformation (HT). In addition, a sufficient number of collateral vessels in acute ischemic stroke can maintain the ischemic penumbra and prevent progression to the ischemic core, while an insufficient number of collateral vessels increase the HT risk after therapeutic recanalization. In this case, when the middle cerebral artery is recanalized, reperfusion injury may occur in the basal ganglia due to insufficient collateral vessels.