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Post-stroke medication adherence and persistence rates: a meta-analysis of observational studies

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Abstract

Background

Following a doctor’s prescribed medication regimen is the key to prevent recurrent stroke and adverse outcomes. Many studies have investigated post-stroke drug adherence and persistence in patients. However, a comprehensive analysis of the data is lacking.

Objectives

A meta-analysis of published literature was conducted to summarize the ratio of medication adherence and persistence in patients after stroke.

Methods

Relevant studies were identified by conducting a literature search using PubMed, EMBASE and Web of Science up to April 2019. We also reviewed the reference list of the retrieved articles to identify additional studies. We included observational studies that reported data on patients’ medication adherence or persistence status, or the rate of medication adherence or persistence among patients with stroke could be calculated based on the information provided.

Results

The overall high medication adherence rate of patients with stroke was 64.1% (95% CI: 57.4%–70.8%), and the persistence rate of patients with stroke was 72.2% (95% CI: 69.1%–75.3%). The highest persistence rate was observed in cohort studies which was 80.1% (95% CI: 76.7%–83.4%). The medication adherence rate was the highest in cases where the rates were assessed through interviews or self-reports (77.7% (95% CI: 71.3%–84.1%)).

Conclusions

Medication adherence and persistence rates are low in patients after suffering a stroke. Patient medication adherence or persistence and their influencing factors should be considered for the treatment of stroke patients. More detailed disease prevention and management strategies need to be developed for stroke patients with different comorbidities.

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Acknowledgements

JZ and XY conceived the study. JZ and YG conducted the literature search. YG identified potentially relevant research based on the title and abstract of the article. JZ and YZ reviewed these potential studies and determined the final included studies according to the inclusion and exclusion criteria. JZ and YG extracted data from the included studies and assessed the quality of the studies. NJ and JW checked the extracted data. JZ and YG analyzed the data and prepared the draft of the manuscript. XY and YG criticized and revised the manuscript. All authors reviewed the study findings and read and approved the final manuscript. XY is the guarantor of this study.

Funding

This study was a part of our routine work.

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Author notes

  1. Jia Zhang and Yanhong Gong have contributed equally to this work.

Authors and Affiliations

  1. School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China

    Jia Zhang, Yanhong Gong, Yuxin Zhao, Nan Jiang, Jing Wang & Xiaoxv Yin

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  1. Jia Zhang
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Correspondence to Xiaoxv Yin.

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Zhang, J., Gong, Y., Zhao, Y. et al. Post-stroke medication adherence and persistence rates: a meta-analysis of observational studies. J Neurol 268, 2090–2098 (2021). https://doi.org/10.1007/s00415-019-09660-y

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