Adherence to pharmacotherapy

Failure to adhere to prescribed medication continues to be a major barrier to the preventing further strokes.

In one large Swedish cohort, the proportion of patients who continued using hospital-prescribed medication after two years was 74.2% for antihypertensives, 56.1% for statins, 63.7% for antiplatelet drugs, and 45.0% for warfarin. A systematic review reported that, in Europe, as much as 9% of all cardiovascular events are directly attributable to poor adherence to vascular medications.

Specific data on medication adherence in Australian patients with stroke is lacking, however a meta-analysis of local studies highlights that non-adherence to cardiovascular medications is high in general; in the older population, the overall prevalence of non-adherence is 14 to 43%.

Information about the specific barriers to medication adherence among patients with stroke is also relatively scarce. However, beliefs about medication, concerns about side-effects, limited knowledge of stroke prevention therapies, inadequate provision of information, inability to self-care, difficulties taking medication, the tendency of the patient with stroke to trivialise stroke, and burden of treatment, have all been cited as key barriers to medication adherence.

For current research and evidence-based recommendations see our Clinical Guidelines.