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Keynote webinar | Spotlight on medication adherence

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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 6/2017

Open Access 01-12-2017 | Original Article

Psychological Determinants of Medication Adherence in Stroke Survivors: a Systematic Review of Observational Studies

Authors: Elise Crayton, MSc, Marion Fahey, MPH, Mark Ashworth, DM, Sarah Jane Besser, PhD, John Weinman, PhD, Alison J. Wright, PhD

Published in: Annals of Behavioral Medicine | Issue 6/2017

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Abstract

Background

Medications targeting stroke risk factors have shown good efficacy, yet adherence is suboptimal. To improve adherence, its determinants must be understood. To date, no systematic review has mapped identified determinants into the Theoretical Domains Framework (TDF) in order to establish a more complete understanding of medication adherence.

Purpose

The aim of this study was to identify psychological determinants that most influence stroke survivors’ medication adherence.

Methods

In line with the prospectively registered protocol (PROSPERO CRD42015016222), five electronic databases were searched (1953–2015). Hand searches of included full text references were undertaken. Two reviewers conducted screening, data extraction and quality assessment. Determinants were mapped into the TDF.

Results

Of 32,825 articles, 12 fulfilled selection criteria (N = 43,984 stroke survivors). Tested determinants mapped into 8/14 TDF domains. Studies were too heterogeneous for meta-analysis. Three TDF domains appeared most influential. Negative emotions (‘Emotions’ domain) such as anxiety and concerns about medications (‘Beliefs about Consequences’ domain) were associated with reduced adherence. Increased adherence was associated with better knowledge of medications (‘Knowledge’ domain) and stronger beliefs about medication necessity (‘Beliefs about Consequences’ domain). Study quality varied, often lacking information on sample size calculations.

Conclusions

This review provides foundations for evidence-based intervention design by establishing psychological determinants most influential in stroke survivors’ medication adherence. Six TDF domains do not appear to have been tested, possibly representing gaps in research design. Future research should standardise and clearly report determinant and medication adherence measurement to facilitate meta-analysis. The range of determinants explored should be broadened to enable more complete understanding of stroke survivors’ medication adherence.
Appendix
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Literature
1.
World Health Organization WHO: Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks: World Health Organization, 2009.
2.
3.
Department of Health DH: National Stroke Strategy. UK: Department of Health, 2007.
4.
National Collaborating Centre for Chronic Condition RCP: Stroke: Diagnosis and Initial Management of Acute Stroke and Transient Ischaemic Attack (TIA). London: Royal College of Physicians, 2008.
5.
Intercollegiate Stroke Working Party RCP: National Clinical Guideline for stroke. London: Royal College of Physicians, 2012.
6.
Sacco RL, Adams R, Albers G, et al.: Guidelines for prevention of stroke in patients with Ischemic stroke or transient Ischemic attack: A statement for healthcare professionals from the American Heart Association/American Stroke Association Council on stroke: Co-sponsored by the council on cardiovascular radiology and intervention: The American Academy of Neurology affirms the value of this guideline. Stroke. 2006, 37:577–617.CrossRefPubMed
7.
Warlow CP, Van Gijn J, Dennis MS, et al.: Stroke: Practical management (3rd Ed.). Oxford: Blackwell, 2008.CrossRef
8.
Yusuf S: Two decades of progress in preventing vascular disease. The Lancet. 2002, 360:2–3.CrossRef
9.
Sappok T, Faulstich A, Stuckert E, et al.: Compliance with secondary prevention of Ischemic stroke: A prospective evaluation. Stroke. 2001, 32:1884–1889.CrossRefPubMed
10.
Nunes V, Neilson J, O’Flynn N, et al.: Clinical guidelines and evidence review for medicines adherence: Involving patients in decisions about prescribed medicines and supporting adherence. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners, 2009.
11.
Al AlShaikh S, Quinn T, Dunn W, Walters M, Dawson J: Predictive factors of non-adherence to secondary preventative medication after stroke or transient Ischaemic attack: A systematic review and meta-Analyses. European Stroke Journal. 2016, 1:65–75.CrossRef
12.
Chambers JA, O’Carroll RE, Hamilton B, et al.: Adherence to medication in stroke survivors: A qualitative Comparison of low and high adherers. British Journal of Health Psychology. 2011, 16:592–609.CrossRefPubMed
13.
O’Carroll R, Whittaker J, Hamilton B, et al.: Predictors of adherence to secondary preventive medication in stroke patients. Annals of Behavioral Medicine. 2011, 41:383–390.CrossRefPubMed
14.
Bauler S, Jacquin-Courtois S, Haesebaert J, et al.: Barriers and facilitators for medication adherence in stroke patients: A qualitative study conducted in French neurological Rehabilitation units. European Neurology. 2014, 72:262–270.CrossRefPubMed
15.
Boan AD, Egan BM, Bachman DL, et al.: Antihypertensive medication persistence 1-year post-stroke hospitalization. The Journal of Clinical Hypertension. 2014, 16:869–874.CrossRefPubMed
16.
Khan MU, Shah S, Hameed T: Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland. Journal of Pharmacy & Bioallied Sciences. 2014, 6:104–108.CrossRef
17.
Vawter L, Tong X, Gemilyan M, Yoon PW: Barriers to antihypertensive medication adherence among adults— United States, 2005. The Journal of Clinical Hypertension. 2008, 10:922–929.CrossRefPubMed
18.
19.
Lager KE, Mistri AK, Khunti K, et al.: Interventions for improving modifiable risk factor control in the secondary prevention of stroke (review). Cochrane Database of Systematic Reviews. 2014, 5:1–94.
20.
Oxford University Press: Oxford English dictionary online. 2001.
21.
Michie S, Johnston M, Francis J, Hardeman W, Eccles M: From theory to intervention: Mapping theoretically derived Behavioural determinants to behaviour change techniques. Applied Psychology. 2008, 57:660–680.CrossRef
22.
Michie S, Wood C, Johnston M, et al.: Behaviour change techniques: The development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technol Assess. 2015, 19.
23.
Ajzen I: From Intentions to actions: A theory of planned behavior. In: J. Kuhl and J. Beckmann (eds), Action control: From cognition to behavior. Berlin, Heidelberg: Springer Berlin Heidelberg, 1985, 11–39.CrossRef
24.
Hochbaum GM: Public participation in medical screening programs: A socio-psychological study. Washington, DC: United States Government Priniting Office 1958.
25.
Rosenstock IM: Why people use health services. Milbank Memorial Fund Quarterly. 1966, 44:94–127.CrossRef
26.
Conner M, Norman P: Predicting Health Behaviour. UK: Open University Press, 2005.
27.
Michie S, Johnston M, Abraham C, et al.: Making psychological theory useful for implementing evidence based practice: A consensus approach. Quality and Safety in Health Care. 2005, 14:26–33.CrossRefPubMedPubMedCentral
28.
Cane J, O’Connor D, Michie S: Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science. 2012, 7:37.CrossRefPubMedPubMedCentral
29.
Cane J, Richardson M, Johnston M, Ladha R, Michie S: From lists of behaviour change techniques (BCTs) to structured hierarchies: Comparison of two methods of developing a hierarchy of BCTs. British Journal of Health Psychology. 2015, 20:130–150.CrossRefPubMed
30.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PG: Preferred reporting items for systematic reviews and meta-Analyses: The PRISMA statement. PLoS Med. 2009, 6:e1000097.CrossRefPubMedPubMedCentral
31.
Haynes RB, Taylor DW, Sackett DL: Compliance in health care (1st Ed.). Baltimore: John Hopkins University Press, 1979.
32.
O’Carroll RE, Chambers JA, Dennis M, Sudlow C, Johnston M: Improving adherence to medication in stroke survivors: A pilot randomised controlled trial. Annals of Behavioral Medicine. 2013, 46:358–368.CrossRefPubMed
33.
Higgins JPT, Green S: Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, 2011.
34.
Walburn J, Gray R, Gournay K, Quraishi S, David AS: Systematic review of patient and nurse attitudes to depot antipsychotic medication. The British Journal of Psychiatry. 2001, 179:300–307.CrossRefPubMed
35.
Cohen J: A coefficient of agreement for nominal scales. Educational and Psychological Measurement. 1960, 20:37–46.CrossRef
36.
Kronish IM, Edmondson D, Goldfinger JZ, Fei K, Horowitz CR: Posttraumatic stress disorder and adherence to medications in survivors of strokes and transient Ischemic attacks. Stroke. 2012, 43:2192–2197.CrossRefPubMedPubMedCentral
37.
Phillips LA, Diefenbach MA, Kronish IM, Negron RM, Horowitz CR: The necessity-concerns framework: A multidimensional theory benefits from multidimensional analysis. Annals of Behavioral Medicine. 2014, 48:7–16.CrossRefPubMedPubMedCentral
38.
Phillips LA, Diefenbach MA, Abrams J, Horowitz CR: Stroke and TIA Survivors' cognitive beliefs and affective responses regarding treatment and Furture stroke risk differentially predict medication adherence and categorised stroke risk. Psychology & Health. 2015, 30:218–232.CrossRef
39.
Coetzee N, Andrewes D, Khan F, et al.: Predicting compliance with treatment Following stroke: A new model of adherence Following Rehabilitation. Brain Impairment. 2008, 9:122–139.CrossRef
40.
Glader E-L, Sjölander M, Eriksson M, Lundberg M: Persistent use of secondary preventive drugs declines rapidly during the first 2 years after stroke. Stroke. 2010, 41:397–401.CrossRefPubMed
41.
Sjölander M, Eriksson M, Glader E-L: Few sex differences in the use of drugs for secondary prevention after stroke: A Nationwide observational study. Pharmacoepidemiology and Drug Safety. 2011, 21:911–919.CrossRefPubMed
42.
Sjölander M, Eriksson M, Glader E-L: The Association Between Patients’ Beliefs about Medicines and Adherence to Drug Treatment after Stroke: A Cross-Sectional Questionnaire Survey. BMJ Open. 2013, 3.
43.
Bushnell CD, Zimmer LO, Pan W, et al.: Persistence with stroke prevention medications 3 months after hospitalization. Archives of Neurology. 2010, 67:1456–1463.CrossRefPubMed
44.
45.
Edmondson D, Horowitz CR, Goldfinger JZ, Fei K, Kronish IM: Concerns about medications mediate the Association of Posttraumatic Stress Disorder with adherence to medication in stroke survivors. British Journal of Health Psychology. 2013, 18:799–813.CrossRefPubMedPubMedCentral
46.
Kronish IM, Diefenbach MA, Edmondson DE, et al.: Key barriers to medication adherence in survivors of strokes and transient Ischemic attacks. Journal of General Internal Medicine. 2013, 28:675–682.
47.
Gentil L, Vasiliadis HM, Préville M, Bossé C, Berbiche D: Association between depressive and anxiety disorders and adherence to antihypertensive medication in community-living elderly adults. Journal of the American Geriatrics Society. 2012, 60:2297–2301.CrossRefPubMed
48.
Koenig KL, Whyte EM, Munin MC, et al.: Stroke-related knowledge and health behaviors among Poststroke patients in inpatient Rehabilitation. Archives of Physical Medicine and Rehabilitation. 2007, 88:1214–1216.CrossRefPubMed
49.
Jamison J, Graffy J, Mullis R, Mant J, Sutton S: Barriers to medication adherence for the secondary prevention of stroke: A qualitative interview study in primary care. The British Journal of General Practice. 2016, 66:e568-e576.CrossRefPubMedPubMedCentral
50.
Horne R, Chapman SCE, Parham R, et al.: Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: A meta-analytic review of the necessity-concerns framework. PLoS ONE. 2013, 8:e80633.CrossRefPubMedPubMedCentral
51.
Barker-Collo S, Krishnamurthi R, Witt E, et al.: Improving adherence to secondary stroke prevention strategies through motivational interviewing. Randomized controlled trial. Stroke. 2015, 46:3451–3458.CrossRefPubMed
52.
Fleetcroft R, Ford J, Gollop ND, et al.: Difficulty accessing data from randomised trials of drugs for heart failure: A call for action. BMJ. 2015, 351:h5002.CrossRefPubMed
53.
Nicholson SL, Donaghy M, Johnston M, et al.: A qualitative theory guided analysis of stroke Survivors' perceived barriers and facilitators to physical activity. Disabil Rehabil. 2014, 36:1857–1868.CrossRefPubMed
Metadata
Title
Psychological Determinants of Medication Adherence in Stroke Survivors: a Systematic Review of Observational Studies
Authors
Elise Crayton, MSc
Marion Fahey, MPH
Mark Ashworth, DM
Sarah Jane Besser, PhD
John Weinman, PhD
Alison J. Wright, PhD
Publication date
01-12-2017
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 6/2017
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-017-9906-0

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