Statin Adherence In Patients With Ischemic Stroke And Its Impact On The Relapse Of Stroke

Objective: To understand statin adherence of the patients with ischemic stroke who had been discharged from hospital for three months, six months and one year. Analyze the causes of patients’ poor adherence and the impact on the relapse of stroke in order to provide evidence for implementing the secondary prevention of ischemic stroke.Methods:A total of 800 patients with ischemic stroke who were admitted in our hospital and diagnosed in the Neurology Department between Oct 1, 2014 and Dec 31, 2014 were consecutively selected. The general clinical data of those patients were recorded, as well as the usage, the reasons of withdrawal(or dose reduction) of statins and the relapse of stroke after been discharged for three months, six months and one year, to compare the relapse rate between the higher-adherence group and lower-adherence group. The statistic software SPSS16.0 is used in this study; P<0.05 so the result is statistically significant.Results:1 General information of selected patients:There were total 678 survived patients with complete information among which were 456 males and 226 females(the ratio was 2.0:1) at the age of 16 to 93 years(average age = 60.13±11.982 years) with 62 youth patients(younger than 44 years old, accounting for 9.15%), 390 middle-aged patients(aged between 45 to 64, accounting for 57.52%) and 226 elder patients(aged over 65, accounting for 33.33%). Those 678 patients included 480 patients with hypertension(accounting for 70.80%), 210 patients complicated with diabetes(accounting for 30.97%), 109 patients complicated with coronary heart disease(accounting for 16.08%) and 183 patients complicated with hyperlipidemia(accounting for 26.99%). A total of 108 patients relapsed; the relapse rate were 15.93%;2 Patients’ adherence of statins:Three months, six months and one year after patients with ischemic stroke had been discharged, the adherence rate of statins were 78.76%, 64.90% and 59.14% respectively. The three adherence rates are lower successively. There were significant differences statistically in comparison between any two groups(P<0.05);3 The causes of patients’ lower adherence : The reasons that caused patients withdraw or reduce medicine dosage included: patients believed the medicine didn ’ t work(29.60%); patients believed they had been recovered(14.80%); there were side effects(7.94%); patients were afraid of possible side effects(9.39%); economic pressure(9.03%); patients changed to take Chinese traditional medicine, Tibetan medicine or health care products(7.22%); and patients took the medicine intermittently, etc. The main reason of the lower adherence rate of statins was that patients believed the medicine didn’t work. The main side effect of statins is abnormal liver function(77.27%), followed by myalgia(13.64%) and gastrointestinal discomfort(9.09%);4 The impact of adherence of statins on the relapse of stroke:One-year follow up after the patients with ischemic stroke had been discharged from the hospital showed that the relapse rate of patients with higher adherence of statins were 12.72%, significantly lower than that of patients with lower adherence of statins, 20.58%(P<0.01)。Conclusions:1 The adherence of patients with ischemic stroke after they had been discharged for three months, six months and one year were different and decreasing significantly.2 The main reason why patients with ischemic stroke have lower adherence of statins is that they felt the medicine couldn’t work. Other reasons successively include feeling recovery, being afraid of possible side effects, economic pressure, side effects, changing to take Chinese traditional medicine, Tibetan medicine or health care products and intermittent usage. The main side effect from the use of statins is abnormal liver function, followed by myalgia and gastrointestinal reactions.3 Statin adherence can impact on the relapse of ischemic stroke, and increase the adherence can reduce the relapse rate. The propaganda and education about the adherence to the patients should be enhanced in order to reduce the relapse rate of stroke.