Predictors of Adherence to Secondary Preventive Medication in Stroke Patients

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.