| ObjectiveTo summarize the relevant factors affecting medication compliance in patients with acute ischemic stroke(AIS),and the relationship between medication compliance and cognitive function.To explore the correlation between the medication compliance of AIS patients and their caregivers,including the assessment of caregiver burden,so that the burden of caregivers can be more reasonably intervened and controlled,and provide a reference for improving patients' medication compliance.MethodsFrom July 2018 to March 2019,217 AIS patients enrolled in the Neurology ward of northern Jiangsu province hospital were admitted in this study.The clinical data and blood tests of these patients were performed.The Montreal cognitive assessment(Mo CA)and Cognition-12(Cog-12)were applied for the cognitive assessments,and the Barthel index was applied for the assessment of daily living ability.According to the medication compliance at(180±7)days,the patients were divided into poor medication compliance group and good medication compliance group.The factor feature of these two groups was compared,and univariate analysis,as well as the multifactor analysis,were conducted to identify the influence factors of medication compliance in AIS patients.Results(1)At the 6 months of follow up,42 lost to follow-up,13 refused follow-up,8 didn't know the medication,and 1 died.Eventually,a total of 153 patients completed follow up.(2)The proportion of drugs at discharge were statins(94.12%),antiplatelet(90.20%),antihypertensive(63.40%),diabetes(30.07%)and warfarin(9.8%)medications.The compliance at 6 months was highest for diabetes(76.09%),followed by antihypertensive(67.01%),antiplatelet(66.67%),statins(58.33%)and warfarin(46.67%)medications.(3)The patients were divided into poor medication compliance group and good medication compliance group,including 68 patients(44.44%)of good medication compliance group and 85 patients(55.56%)of poor medication compliance group.The average age of the former group was 63.72 ± 10.51 years old and 64.7% of the patients were male.The average age of the latter group was 65.34 ± 10.78 years old and 57.6% of the patients were male.The patients with a history of diabetes,coronary heart disease and higher National Institute of Health Stroke Scale(NIHSS)score were associated with good medication compliance(P<0.05).(4)Higher scores on visuospatial and executive function,attention and total score of Mo CA,were associated with good medication compliance(P<0.05).There was no significant difference in the Cog-12 or Barthel index scores between the groups(P>0.05).(5)Leukocytes,neutrophils,monocytes,lymphocytes,urea nitrogen,creatinine,uric acid,homocysteine,glycated hemoglobin,high-density lipoprotein,low-density lipoprotein,triglycerides,and cholesterol had no statistically significant difference on medication compliance(P>0.05).(6)The average age of good medication compliance group was 59.28±11.18 years old and 38.2% of the patients were male.The average age of poor medication compliance group was 60.59±12.79 years old and 44.7% of the patients were male.Among caregiverrelated factors,the higher family monthly income and the shorter duration of care were associated with good medication compliance(P<0.05).(7)The time-dependent burden score of the Caregiver Burden Inventory(CBI)of the caregivers in the poor compliance group were significantly lower than that in the good compliance group,and the emotional burden was significantly higher than that in the good compliance group(P<0.05).(8)Multivariable Logistic regression analysis showed that the independent predictors of six-month medication persistence included NIHSS score(OR = 0.397,95% CI: 0.212-0.743,P = 0.004),and the duration of care(OR = 1.251,95% CI: 1.085-1.443,P = 0.002),time-dependent burden(OR = 0.635,95% CI: 0.437 to 0.921,P = 0.017)and emotional burden(OR = 0.656,95% CI: 0.446 to 0.966,P = 0.033).ConclusionsPoor medication compliance is prevalent among AIS patients and needs to be further improved.The stroke severity of AIS patients has a certain effect on medication compliance.This study found no association between medication adherence and cognitive impairment.Attention should be paid to the role of caregivers in improving patients' medication compliance,and effective countermeasures should be taken to improve medication compliance. |
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