Chapman Beatrice, Bogle Vanessa
Research and Project Manager at Visions4health Ltd.
Health Psychology Supervisor and Visiting Lecturer at City University London.
Br J Nurs. 2014;23(3):158-66. doi: 10.12968/bjon.2014.23.3.158.
Stroke is the third most common cause of mortality and one of the leading causes of adult physical disability in England. Medical treatment is imperative for the management of stroke and the risk reduction of recurrent stroke. The success of a medical treatment is determined largely by adherence. However, research has shown that adherence to medication in patients who have had a stroke is often suboptimal. Self-management interventions have been shown to improve adherence in long-term conditions. The impact of self-management interventions specifically on adherence to stroke medication is unknown.
To review systematically the impact that self-management interventions have on adherence to stroke medication.
The online databases that were systematically searched included PsychINFO, MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews, CINAHL and Web of Science. Reference lists of retrieved studies were hand-searched.
Six studies met the criteria for inclusion in the systematic review. Self-management interventions for stroke patients were effective in improving adherence to stroke medication in the short term. However, in the longer term, these benefits were not maintained.
Applying self-management interventions to improve medication adherence in stroke patients across integrated clinical settings shows promise. However, further development of such interventions and research is recommended, with more stringent methodologies and longer follow-up periods.
在英格兰，中风是第三大常见死因，也是成人身体残疾的主要原因之一。药物治疗对于中风的管理和降低复发性中风的风险至关重要。药物治疗的成功很大程度上取决于依从性。然而，研究表明，中风患者的药物依从性往往不理想。自我管理干预已被证明可提高长期疾病患者的依从性。自我管理干预对中风药物依从性的具体影响尚不清楚。
系统评价自我管理干预对中风药物依从性的影响。
系统检索的在线数据库包括PsychINFO、MEDLINE、EMBASE、Scopus、Cochrane系统评价数据库、CINAHL和科学网。对检索到的研究的参考文献列表进行手工检索。
六项研究符合纳入系统评价的标准。中风患者的自我管理干预在短期内能有效提高对中风药物的依从性。然而，从长期来看，这些益处并未持续。
在综合临床环境中应用自我管理干预来提高中风患者的药物依从性显示出前景。然而，建议进一步开发此类干预措施并进行研究，采用更严格的方法和更长的随访期。
