TY - JOUR
T1 - Understanding of medications and associations with adherence, unmet needs, and perceived control of risk factors at two years post-stroke
AU - On behalf of the PRECISE investigators
AU - Dalli, Lachlan L.
AU - Andrew, Nadine E.
AU - Kim, Joosup
AU - Cadilhac, Dominique A.
AU - Sanfilippo, Frank M.
AU - Thrift, Amanda G.
AU - Nelson, Mark R.
AU - Lannin, Natasha A.
AU - Olaiya, Muideen T.
AU - Ryan, Olivia F.
AU - Booth, Brenda
AU - Gall, Seana
AU - Kilkenny, Monique F.
N1 - Funding Information:
This work was supported by the National Health and Medical Research Council (NHMRC) of Australia (# 1141848 ). The Australian Stroke Clinical Registry received funding from a range of government, non-government and industry sources. LLD is supported by an Australian Government Research Training Program Scholarship . The following authors reported receiving Research Fellowship or Synergy Grant support from the NHMRC : AGT (# 1042600 ), DAC (# 1154273 ), and SG (# 1182071 ). The following authors reported receiving Research Fellowship support from the National Heart Foundation of Australia : NAL (# 102055 ), MFK (# 105737 ), and SG (# 102061 ).
Funding Information:
Staff from Monash University were responsible for receiving and entering the de-identified survey responses in a REDCap database.15 Each survey contained a project-specific unique identification number to allow staff from the AuSCR to subsequently re-identify and link these responses with the identification number that was specific to the registry data only. The Australian Institute of Health and Welfare also linked these responses with person-level data from the Pharmaceutical Benefits Scheme. The Pharmaceutical Benefits Scheme is a national health scheme funded by the Federal Government to provide Australian residents with access to subsidized prescription medications to make medicines more affordable.16This work was supported by the National Health and Medical Research Council (NHMRC) of Australia (#1141848). The Australian Stroke Clinical Registry received funding from a range of government, non-government and industry sources. LLD is supported by an Australian Government Research Training Program Scholarship. The following authors reported receiving Research Fellowship or Synergy Grant support from the NHMRC: AGT (#1042600), DAC (#1154273), and SG (#1182071). The following authors reported receiving Research Fellowship support from the National Heart Foundation of Australia: NAL (#102055), MFK (#105737), and SG (#102061).DAC is the current Data Custodian for the Australian Stroke Clinical Registry (AuSCR). DAC, NAL, and MFK are members of the AuSCR Steering and/or Management Committees. AGT is a member of the Board of the Stroke Foundation. DAC reported receiving restricted grants from Amgen, Boehringer Ingelheim, Ipsen, Medtronic and Shire outside the submitted work. MFK reported receiving restricted grants from Amgen outside the submitted work. All other authors report no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding Information:
DAC is the current Data Custodian for the Australian Stroke Clinical Registry (AuSCR). DAC, NAL, and MFK are members of the AuSCR Steering and/or Management Committees. AGT is a member of the Board of the Stroke Foundation. DAC reported receiving restricted grants from Amgen , Boehringer Ingelheim , Ipsen , Medtronic and Shire outside the submitted work. MFK reported receiving restricted grants from Amgen outside the submitted work. All other authors report no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Publisher Copyright:
© 2022
PY - 2022/9
Y1 - 2022/9
N2 - Background: It is unclear whether survivors of stroke or transient ischemic attack (TIA) routinely receive, and understand, education about secondary prevention medications. Objectives: To investigate whether survivors of stroke/TIA understand explanations about their prescribed prevention medications and associations with medication adherence, control of risk factors, and unmet needs. Methods: A survey was administered among survivors of stroke/TIA (random sample N = 1500) from the Australian Stroke Clinical Registry (Victoria and Queensland, 2016). Participants reported whether they understood explanations about each prescribed medication, as well as their unmet needs, perceived control of risk factors, and 30-day medication adherence. Linked pharmacy claims data were also used to determine medication adherence in the previous two years (proportion of days covered ≥80%). Outcomes were analyzed using multivariable logistic regression or multivariable negative binomial regression for frequency of unmet needs. Results: Overall, 630/1455 eligible survivors completed the survey at ≈2.5 years post-admission (median age 69 years; 37% female). Most participants reported using prevention medications (76% antihypertensive; 84% antithrombotic; 76% lipid-lowering) but only 66–75% reported they understood explanations about their medication (75% antihypertensive; 66% antithrombotic; 74% lipid-lowering). Participants who understood explanations about their medication more often reported 30-day adherence for antihypertensive (adjusted odds ratios [aOR]: 1.96; 95% CI: 1.20–3.19), antithrombotic (aOR: 2.03; 95% CI: 1.31–3.14) and lipid-lowering medications (aOR: 1.73; 95% CI: 1.08–2.76). Similar associations were observed for antihypertensive and antithrombotic medications when pharmacy claims data were used to infer 2-year medication adherence. Understanding explanations about medications was also associated with perceived control of risk factors (hypertension: aOR: 11.08; 95% CI: 6.04–20.34; cholesterol aOR: 8.26; 95% CI: 4.72–14.47) and up to 33% fewer unmet needs related to secondary prevention. Conclusions: Expanded efforts are needed to improve the delivery of information about prevention medications to promote medication adherence, control of risk factors, and potentially prevent unmet needs following stroke/TIA.
AB - Background: It is unclear whether survivors of stroke or transient ischemic attack (TIA) routinely receive, and understand, education about secondary prevention medications. Objectives: To investigate whether survivors of stroke/TIA understand explanations about their prescribed prevention medications and associations with medication adherence, control of risk factors, and unmet needs. Methods: A survey was administered among survivors of stroke/TIA (random sample N = 1500) from the Australian Stroke Clinical Registry (Victoria and Queensland, 2016). Participants reported whether they understood explanations about each prescribed medication, as well as their unmet needs, perceived control of risk factors, and 30-day medication adherence. Linked pharmacy claims data were also used to determine medication adherence in the previous two years (proportion of days covered ≥80%). Outcomes were analyzed using multivariable logistic regression or multivariable negative binomial regression for frequency of unmet needs. Results: Overall, 630/1455 eligible survivors completed the survey at ≈2.5 years post-admission (median age 69 years; 37% female). Most participants reported using prevention medications (76% antihypertensive; 84% antithrombotic; 76% lipid-lowering) but only 66–75% reported they understood explanations about their medication (75% antihypertensive; 66% antithrombotic; 74% lipid-lowering). Participants who understood explanations about their medication more often reported 30-day adherence for antihypertensive (adjusted odds ratios [aOR]: 1.96; 95% CI: 1.20–3.19), antithrombotic (aOR: 2.03; 95% CI: 1.31–3.14) and lipid-lowering medications (aOR: 1.73; 95% CI: 1.08–2.76). Similar associations were observed for antihypertensive and antithrombotic medications when pharmacy claims data were used to infer 2-year medication adherence. Understanding explanations about medications was also associated with perceived control of risk factors (hypertension: aOR: 11.08; 95% CI: 6.04–20.34; cholesterol aOR: 8.26; 95% CI: 4.72–14.47) and up to 33% fewer unmet needs related to secondary prevention. Conclusions: Expanded efforts are needed to improve the delivery of information about prevention medications to promote medication adherence, control of risk factors, and potentially prevent unmet needs following stroke/TIA.
KW - Medication adherence
KW - Medication counselling
KW - Patient understanding
KW - Patient-reported outcomes
KW - Pharmacoepidemiology
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85123610711&partnerID=8YFLogxK
U2 - 10.1016/j.sapharm.2022.01.007
DO - 10.1016/j.sapharm.2022.01.007
M3 - Article
C2 - 35093283
AN - SCOPUS:85123610711
SN - 1551-7411
VL - 18
SP - 3542
EP - 3549
JO - Research in Social and Administrative Pharmacy
JF - Research in Social and Administrative Pharmacy
IS - 9
ER -