| Objectives We recently investigated the influenciong factors of one-year composite secondary prevention medication adherence in patients with acute ischemic stroke?AIS?or transient ischemic attack?TIA?.Methods Subjects were obtained from the Second Department of Neurology,Tangshan Gongren Hospital's secondary prevention registration database of patients who have suffered an AIS or TIA.The database registers patients who presented with AIS or TIA and were hospitalized in the Second Department of Neurology,Tangshan Gongren Hospital from January 1st,2012 to December 31st,2016.We screened cases based on inclusion and exclusion criteria to conduct a retrospective analysis.The baseline and follow-up data of the subjects were obtained from the database.The baseline data included demographic information,personal history,past history,condition profile,and discharge medications.The medications included antithrombotic drugs?antiplatelet drugs and anticoagulant drugs?,antihypertensive drugs,statins,and hypoglycemic drugs.We obtained information from the database concerning whether each patient has been taking the one medication since the last follow-up for three months,six months,and 12 months.The compliance rate was calculated as the ratio of the cumulative duration of the therapy and the duration of overall follow-up.A compliance rate of?75%was defined as adherence,while a compliance rate of<75%was defined as non-adherence.The one-year composite adherence rate of secondary prevention medications was the ratio of the number of drugs defined as“adherence”at the 12-month follow-up and the number of discharge medications.A one-year composite adherence rate of?75%was considered high adherence and<75%was considered low adherence.According to patients'one-year medication composite adherence,patients were divided into two groups:a high adherence group and a low adherence group.A multivariable logistic regression was used to examine the factors associated with composite adherence one year after discharge.ResultsA total of 2926 patients were included in the study,including 1257 patients?43.0%?with high adherence and 1669 patients?57.0%?with low adherence.Patient age,medicare type,family monthly income,a previous history of hypertension,a previous history of diabetes,a previous history of lipid metabolism disorder,a previous history of cerebral infarction,previous antithrombotic drugs use,previous antihypertensive drugs use,previous lipid-lowering drugs use,previous hypoglycemic drugs use,cerebrovascular disease type,the number of drugs on discharge from hospital and hospitalization expenses were statistically significant betweent the two groups?P<0.05?.Multivariate logistic regression analysis showed that composite medication adherence was significantly associated with age?Q4 VS Q1:OR=0.703,95%CI 0.5590.884,P=0.003?,a history of hypertension?OR=1.317,95%CI 1.0501.651,P=0.017?,a history of lipid metabolism disorders?OR=1.424,95%CI 1.1001.845,P=0.007?,a history of antihypertensive drugs?OR=1.407,95%CI 1.1321.749,P=0.002?,a history of hypoglycemic drugs?OR=1.712,95%CI 1.3522.166,P<0.001?,cerebrovascular disease type?ischemic stroke VS TIA:OR=0.709,95%CI 0.5390.931,P=0.014?,the number of drugs on discharge from hospital?2 kinds VS 1 kind:OR=0.329,95%CI0.2660.406,P<0.001;3 kinds VS 1 kind:OR=0.116,95%CI 0.0900.149,P<0.001;4 kinds vs 1 kind:OR=0.338,95%CI 0.2400.477,P<0.001?and hospitalization expenses?Q2 VS Q1:OR=1.555,95%CI 1.2401.950,P<0.001;Q3VS Q1:OR=1.505,95%CI?1.1981.892?,P<0.001;Q4 VS Q1:OR=1.907,95%CI 1.5202.393,P<0.001?.Conclusions1 Among all patients,patients with who were younger,who had previous hypertension or lipid metabolism disorders,who had previously taken antihypertensive drugs or hypoglycemic drugs,who were prescribedfewer types of drugs on discharge from hospital and those with higher hospitalization expenses had higher one-year composite adherence.2 Patients with AIS were found to have better one-year composite adherence than thos with TIA.Figure1;Table8;Reference 121. |
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