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Published in: Annals of Behavioral Medicine 3/2011

01-06-2011 | Original Article

Predictors of Adherence to Secondary Preventive Medication in Stroke Patients

Authors: Ronan O’Carroll, Ph.D., Jennifer Whittaker, M.Sc., Barbara Hamilton, B.Sc., Marie Johnston, Ph.D., Cathie Sudlow, D.Phil., Martin Dennis, M.D.

Published in: Annals of Behavioral Medicine | Issue 3/2011

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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.
Literature
1.
go back to reference World Health Organisation. Adherence to long-term therapies: Evidence for action. Geneva: WHO; 2003. World Health Organisation. Adherence to long-term therapies: Evidence for action. Geneva: WHO; 2003.
2.
go back to reference Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence (Review). The Cochrane Collaboration, 4; 2008. Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence (Review). The Cochrane Collaboration, 4; 2008.
3.
go back to reference National Institute for Clinical Excellence, UK. Medicines adherence, Clinical Guideline, 76; 2009. National Institute for Clinical Excellence, UK. Medicines adherence, Clinical Guideline, 76; 2009.
4.
go back to reference Scottish Intercollegiate Guidelines Network. Management of patients with stroke or TIA: assessment, investigation, immediate management and secondary prevention—A national guideline. Guideline 108. Edinburgh: SIGN; 2008 Scottish Intercollegiate Guidelines Network. Management of patients with stroke or TIA: assessment, investigation, immediate management and secondary prevention—A national guideline. Guideline 108. Edinburgh: SIGN; 2008
5.
go back to reference Stephenson J. Noncompliance may cause half of antihypertensive drug "failures". JAMA. 1999; 282[4]: 313-314.PubMedCrossRef Stephenson J. Noncompliance may cause half of antihypertensive drug "failures". JAMA. 1999; 282[4]: 313-314.PubMedCrossRef
6.
go back to reference Hayes TL, Larimer N, Adami A, Kaye JA. Medication adherence in healthy elders: small cognitive changes make a big difference. J Aging Health. 2009; 21[4]: 567-580.PubMedCrossRef Hayes TL, Larimer N, Adami A, Kaye JA. Medication adherence in healthy elders: small cognitive changes make a big difference. J Aging Health. 2009; 21[4]: 567-580.PubMedCrossRef
7.
go back to reference Fischer B, Lehrl S, Weber E, Gundert-Remy U, Fischer, U. [Cerebrovascular insufficiency and compliance with drug therapy]. Z Gerontol. 1981; 14[2]: 145-152.PubMed Fischer B, Lehrl S, Weber E, Gundert-Remy U, Fischer, U. [Cerebrovascular insufficiency and compliance with drug therapy]. Z Gerontol. 1981; 14[2]: 145-152.PubMed
8.
go back to reference Leventhal H, Diefenbach M. Illness cognition: using common sense to understand treatment adherence and affect cognition interactions. Cognit Ther and Res. 1992; 16[2]: 143-163.CrossRef Leventhal H, Diefenbach M. Illness cognition: using common sense to understand treatment adherence and affect cognition interactions. Cognit Ther and Res. 1992; 16[2]: 143-163.CrossRef
9.
go back to reference Meyer D, Leventhal H, Gutmann M. Common-sense models of illness: the example of hypertension. Health Psychol. 1985; 4: 5-135.CrossRef Meyer D, Leventhal H, Gutmann M. Common-sense models of illness: the example of hypertension. Health Psychol. 1985; 4: 5-135.CrossRef
10.
go back to reference Brewer NT, Chapman GB, Brownlee S, Leventhal EA. Cholesterol control medication adherence and illness cognition. Br J Health Psychol. 2002; 7(Part 4): 433-447.PubMedCrossRef Brewer NT, Chapman GB, Brownlee S, Leventhal EA. Cholesterol control medication adherence and illness cognition. Br J Health Psychol. 2002; 7(Part 4): 433-447.PubMedCrossRef
11.
go back to reference Horne R. Measuring adherence: the case for self-report. Intl J Behavioral Med. 2004; 11:75. Horne R. Measuring adherence: the case for self-report. Intl J Behavioral Med. 2004; 11:75.
12.
go back to reference Trewby PN, Reddy AV, Trewby CS, Ashton VJ, Brennan G, Inglis J. Are preventive drugs preventive enough? A study of patients' expectation of benefit from preventive drugs. Clin Med. 2002; 2[6]: 527-533.PubMed Trewby PN, Reddy AV, Trewby CS, Ashton VJ, Brennan G, Inglis J. Are preventive drugs preventive enough? A study of patients' expectation of benefit from preventive drugs. Clin Med. 2002; 2[6]: 527-533.PubMed
13.
go back to reference Enderby PM, Wood VA, Wade DT, Hewer RL. The Frenchay Aphasia Screening Test: a short simple test for aphasia appropriate for non-specialists. Int Rehabil Med. 1987; 8[4]: 166-170.PubMed Enderby PM, Wood VA, Wade DT, Hewer RL. The Frenchay Aphasia Screening Test: a short simple test for aphasia appropriate for non-specialists. Int Rehabil Med. 1987; 8[4]: 166-170.PubMed
14.
go back to reference Baxter GJ, Lawrence JR, Graham AB, Wiles D, Paterson JR. Identification and determination of salicylic acid and salicyluric acid in urine of people not taking salicylate drugs. Ann Clin Biochem. 2002; 39(Pt 1): 50-55.PubMedCrossRef Baxter GJ, Lawrence JR, Graham AB, Wiles D, Paterson JR. Identification and determination of salicylic acid and salicyluric acid in urine of people not taking salicylate drugs. Ann Clin Biochem. 2002; 39(Pt 1): 50-55.PubMedCrossRef
15.
go back to reference Hays RD, Corporation TR. A five-item measure of socially desirable response set. Educ Psychol Meas. 1989; 49: 629-636.CrossRef Hays RD, Corporation TR. A five-item measure of socially desirable response set. Educ Psychol Meas. 1989; 49: 629-636.CrossRef
16.
go back to reference Bartels H, Bohmer M, Heierli C. Serum creatinine determination without protein precipitation. Clin Chim Acta. 1972; 37: 193-197.PubMedCrossRef Bartels H, Bohmer M, Heierli C. Serum creatinine determination without protein precipitation. Clin Chim Acta. 1972; 37: 193-197.PubMedCrossRef
17.
go back to reference McLoone P. Carstairs scores for Scottish Postcode Sectors from the 2001 census. MRC Social and Public Health Sciences Unit. Glasgow: MRC; 2004 McLoone P. Carstairs scores for Scottish Postcode Sectors from the 2001 census. MRC Social and Public Health Sciences Unit. Glasgow: MRC; 2004
18.
go back to reference Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12: 189-198.PubMedCrossRef Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12: 189-198.PubMedCrossRef
19.
go back to reference Wilson B, Cockburn J, Baddeley AD. Rivermead Behavioural Memory Test, Titchfield, Fareham: Thames Valley Test Co; 1985. Wilson B, Cockburn J, Baddeley AD. Rivermead Behavioural Memory Test, Titchfield, Fareham: Thames Valley Test Co; 1985.
20.
go back to reference O'Carroll RE, McGregor LM, Swanson V, Masterton G, Hayes PC. Adherence to medication after liver transplantation in Scotland: a pilot study. Liver Transpl. 2006; 12[12]: 1862-1868.PubMedCrossRef O'Carroll RE, McGregor LM, Swanson V, Masterton G, Hayes PC. Adherence to medication after liver transplantation in Scotland: a pilot study. Liver Transpl. 2006; 12[12]: 1862-1868.PubMedCrossRef
21.
go back to reference Moss-Morris R, Weinman J, Petrie KJ, Horne R, Cameron LD, Buick D. The Revised Illness Perception Questionnaire (IPQ-R). Psychol Health. 2002; 16: 1-15.CrossRef Moss-Morris R, Weinman J, Petrie KJ, Horne R, Cameron LD, Buick D. The Revised Illness Perception Questionnaire (IPQ-R). Psychol Health. 2002; 16: 1-15.CrossRef
22.
go back to reference Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999; 14: 1-24.CrossRef Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999; 14: 1-24.CrossRef
23.
go back to reference Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983; 67:361-370.PubMedCrossRef Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983; 67:361-370.PubMedCrossRef
24.
go back to reference Field A. Discovering statistics using SPSS (2nd ed). London: Sage; 2005. Field A. Discovering statistics using SPSS (2nd ed). London: Sage; 2005.
25.
go back to reference Tabachnick BG, Fidell LS. Using multivariate statistics (4th ed). Needham Heights, MA: Allyn Bacon; 2001. Tabachnick BG, Fidell LS. Using multivariate statistics (4th ed). Needham Heights, MA: Allyn Bacon; 2001.
26.
go back to reference Leventhal H, Weinman J, Leventhal EA, Phillips LA. Health psychology: The search for pathways between behavior and health. Annu Rev Psychol. 2008; 59: 477-505.PubMedCrossRef Leventhal H, Weinman J, Leventhal EA, Phillips LA. Health psychology: The search for pathways between behavior and health. Annu Rev Psychol. 2008; 59: 477-505.PubMedCrossRef
27.
go back to reference O'Carroll RE, Dennis M, Johnston M, Sudlow C. Improving adherence to medication in stroke survivors (IAMSS): A randomised controlled trial: Study protocol BMC Neurol. 2010; 10:15.PubMedCrossRef O'Carroll RE, Dennis M, Johnston M, Sudlow C. Improving adherence to medication in stroke survivors (IAMSS): A randomised controlled trial: Study protocol BMC Neurol. 2010; 10:15.PubMedCrossRef
Metadata
Title
Predictors of Adherence to Secondary Preventive Medication in Stroke Patients
Authors
Ronan O’Carroll, Ph.D.
Jennifer Whittaker, M.Sc.
Barbara Hamilton, B.Sc.
Marie Johnston, Ph.D.
Cathie Sudlow, D.Phil.
Martin Dennis, M.D.
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 3/2011
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-010-9257-6

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