Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Tan Tock Seng Hospital, Singapore, Singapore.
J Clin Nurs. 2017 Dec;26(23-24):5016-5024. doi: 10.1111/jocn.14001. Epub 2017 Oct 8.
To investigate the independent predictors of medication adherence among Singaporean patients following an ischaemic stroke or transient ischaemic attack.
Secondary prevention of stroke includes optimal control over modifiable risk factors, and medication adherence is important in controlling the effect of comorbidities. However, there is a paucity of published literature on the topics of medication adherence among stroke patients, especially in the Asian population.
A cross-sectional, descriptive, correlational study.
One hundred and twenty-one patients with ischaemic stroke or transient ischaemic attack were recruited from a tertiary hospital in Singapore. Data collection included the Morisky Medication Adherence Scale-8 (MMAS-8), General Self-Efficacy Survey (GSES) and Medical Outcome Study Social Support Survey. Multiple linear regression analyses were used to evaluate predictors of medication adherence, measured by MMAS-8.
The mean score of the MMAS-8 was 5.07 (SD = 2.20, range 0-8), and more than 80% of the participants had low (n = 65, 53.7%) or medium (n = 34, 28.1%) levels of medication adherence. Multivariate linear regression analysis showed that two factors, namely "understanding the benefits of medications" (β = 0.238, p = .010) and "having suffered from stroke twice or more" (β = 0.235, p = .014), were identified as independent predictors of medication adherence in stroke patients while the other variables were adjusted. These two factors accounted for 12.4% of the variance.
Medication adherence was poor in Singaporean patients following an ischaemic stroke or transient ischaemic attack. The independent predictors identified in this study will support healthcare professionals to develop tailored intervention to improve medication adherence among this group of patients.
Nurses play an important role in promoting patients' medication adherence. Helping stroke patients understand the long-term benefits of their medications is essential to enhance patients' medication adherence and results in better health outcomes.
调查新加坡缺血性卒中和短暂性脑缺血发作患者药物治疗依从性的独立预测因素。
卒中二级预防包括对可改变的危险因素进行最佳控制，而药物治疗依从性对于控制合并症的影响很重要。然而，关于卒中患者药物治疗依从性的文献很少，尤其是在亚洲人群中。
这是一项横断面、描述性、相关性研究。
从新加坡一家三级医院招募了 121 名缺血性卒中和短暂性脑缺血发作患者。数据收集包括 Morisky 药物治疗依从性量表-8（MMAS-8）、一般自我效能感量表（GSES）和医疗结局研究社会支持量表。使用多元线性回归分析评估 MMAS-8 测量的药物治疗依从性的预测因素。
MMAS-8 的平均得分为 5.07（SD=2.20，范围 0-8），超过 80%的参与者药物治疗依从性水平较低（n=65，53.7%）或中等（n=34，28.1%）。多元线性回归分析显示，两个因素，即“了解药物的益处”（β=0.238，p=.010）和“曾两次或多次发生卒中”（β=0.235，p=.014），被确定为卒中患者药物治疗依从性的独立预测因素，同时调整了其他变量。这两个因素占方差的 12.4%。
新加坡缺血性卒中和短暂性脑缺血发作患者的药物治疗依从性较差。本研究确定的独立预测因素将支持医疗保健专业人员制定针对该人群的个性化干预措施，以提高药物治疗依从性。
护士在促进患者药物治疗依从性方面发挥着重要作用。帮助卒中患者了解其药物的长期益处对于提高患者的药物治疗依从性并获得更好的健康结果至关重要。
