| ObjectiveThe purpose of this paper is to investigate the status quo of compliance with antithrombotic drugs for secondary prevention in patients with ischemic cerebrovascular disease,analyze the influencing factors of drug compliance,and explore the influence of secondary prevention drug compliance on the prognosis of patients.Methods350 patients with ischemic cerebrovascular disease who were hospitalized in Department of Neurology of Zhengzhou Yihe hospital from July 2017 to July 2018 were investigated by questionnaire survey.The medication situation,TIA and stroke recurrence of patients within one year from hospitalization to discharge were counted.The criteria of good or poor drug compliance were as follows: 80% of the total follow-up days was considered as good drug compliance,and < 80% of the total follow-up days was considered as poor drug compliance.SPSS23.0 statistical software was used to analyze the following items: analysis of risk factors of ischemic cerebrovascular disease;analysis of antithrombotic drug use and its compliance trend at different time points;analysis of influencing factors of drug compliance;analysis of the impact of drug compliance on prognosis.Results1.Multivariate analysis of risk factors of ischemic cerebrovascular disease: age,obesity,hypertension,diabetes,family history of ischemic cerebrovascular disease,dyslipidemia were all risk factors for the occurrence of ischemic cerebrovascular disease,P values were0.034,0.044,0.026,0.034,0.047,0.034,respectively,all less than 0.05,the difference was statistically significant;2.Drug administration: with the extension of discharge time,the proportion of patients taking antithrombotic drugs gradually decreased,the specific proportion comparison was 12 months after discharge(48.57%)< 6 months after discharge(74.29%)< 1 month after discharge(88.00%)< during hospitalization(97.14%);3.Drug compliance factor analysis: patient age,gender differences,psychological status and personality characteristics were not the main factors leading to poor medication compliance,P values were 0.089,0.070,0.077 and 0.070,respectively.In the process of analyzing the education level and economic status of patients,the P values were 0.034 and0.040,respectively,which were less than 0.05,and the difference was statistically significant;4.Analysis of the effect of drug compliance on the prognosis of patients: 170patients(48.57%)had good drug compliance at 12 months after discharge.High educational level(χ~2 = 4.078,P = 0.026),high family income(χ~2 = 5.024,P = 0.031),history of diabetes(χ~2 = 5.014,P = 0.029),and health insurance(χ~2 = 4.978,P = 0.025)were able to improve drug compliance in patients.After 12 months,19 patients(11.23%)with good drug compliance had a modified Rankin Scale(mRS)score ≥ 3 and 39 patients(21.82%)with poor compliance,and the mRS score in the poor compliance group was significantly higher than that in the good compliance group(χ~2 = 7.378,P = 0.03).A total of 22 patients had TIA or recurrence of cerebral infarction after 12 months,including 2patients(1.17%)with good compliance and 20 patients(11.2%)with poor compliance.Good drug compliance was an independent protective factor for preventing recurrence of stroke(OR = 0.042,95% CI 0.008 ～ 0.210,P < 0.01).Conclusion1.With the prolongation of discharge time,the medication compliance of patients gradually decreased.Medication compliance at 12 months after discharge was generally poor in ischemic stroke patients.High educational level,high family income,history of diabetes,and health insurance can improve patient medication compliance.2.Good drug compliance is an independent protective factor for preventing the recurrence of ischemic stroke. |
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