The following is a summary of “Determinants of adherence to post-stroke/transient ischemic attack secondary prevention medications: A cohort study,” published in the July 2024 issue of Neurology by Hoarau et al.

Researchers conducted a prospective study to examine medication adherence for patients with secondary prevention in ischemic stroke/transient ischemic attack over three years, using prescription data to identify factors affecting compliance.

They involved patients from the STROKE 69 cohort, encompassing all consecutive patients with suspected acute stroke admitted (November 2015 and December 2016) to emergency departments or stroke centers in the Rhône area, France. Prescription data was collected for antihypertensive agents, antidiabetic agents, lipid-lowering drugs, and antithrombotics. Dispensing data were obtained from the French regional reimbursement database. Adherence was assessed using the continuous medication acquisition index. Univariate and multivariate analyses explored associations between suboptimal adherence and potential influencing factors across the WHO’s five dimensions.

Out of 1512 patients, researchers included 365. Optimal adherence to overall treatment (≥90%) was noticed in patients 61%, 62%, and 65% in the first, second, and third years. Education level (high school diploma or higher: OR = 3.24, 95% CI [1.49; 7.36]) and depression (Hospital Anxiety and Depression Scale–Depression scores 8–10: OR = 1.90, 95% CI [1.05; 3.44]) were notably linked with suboptimal adherence.

Investigators concluded that while overall adherence to preventive medications was positive, factors like initial transient ischemic attack diagnosis, higher education, or depression correlated with lower adherence, while a history of heart rhythm disorder showed the opposite.

Source: onlinelibrary.wiley.com/doi/full/10.1111/ene.16395