Chung Pil-Wook, Yoon Byung-Woo, Lee Yeong-Bae, Shin Byoung-Soo, Kim Hahn Young, Park Jae Hyeon, Kim Byung-Kun, Yoo Bong-Goo, Shin Won-Chul, Kim Eung-Gyu, Do Jin Kuk, Park Kyung-Pil, Jung Yohan, Seo Woo-Keun, Han Moon-Ku, Kim Jei, Kim Yongduk, Bang Oh Young, Hwang Yang-Ha, Cha Jin-Hye, Kim Young-Joo
Department of Neurology, Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Neurology, Seoul National University Hospital, Seoul, Republic of
Eur Neurol. 2018;80(1-2):106-114. doi: 10.1159/000493530. Epub 2018 Oct 22.
Although statins are established therapy for the secondary prevention of ischemic stroke, factors associated with adherence to statin treatment following ischemic stroke are not well known. To address this, we assessed the 6-month statin adherence using 8-item Morisky Medication Adherence Scale-8 in patients with acute ischemic stroke. Of 991 patients, 65.6% were adherent to statin at 6-month after discharge. Multiple logistic regression analysis showed that patients' awareness of hyperlipidemia (OR 1.62; 95% CI 1.07-2.43), large artery stroke subtype (versus non-large artery stroke, OR 1.79; 95% CI 1.19-2.68), and alcohol drinking habits (OR 1.64; 95% CI 1.06-2.53) were positively associated, while high statin dose (versus low dose, OR 0.6; 95% CI 0.40-0.90) and higher daily number of medication pills (OR 0.93; 95% CI 0.88-0.97) were found to have a negative association with self-reported good adherence to statin medication after acute ischemic stroke. However, stroke severity and diagnosis of hyperlipidemia were not associated with adherence. These results suggest that educational and motivational interventions may enhance statin adherence because modifiable factors were associated with statin adherence.
尽管他汀类药物是缺血性中风二级预防的既定疗法,但缺血性中风后与他汀类药物治疗依从性相关的因素尚不清楚。为了解决这个问题,我们使用8项Morisky药物依从性量表-8评估了急性缺血性中风患者6个月的他汀类药物依从性。在991例患者中,65.6%在出院后6个月时坚持服用他汀类药物。多因素logistic回归分析显示,患者对高脂血症的认知(比值比1.62;95%置信区间1.07-2.43)、大动脉中风亚型(与非大动脉中风相比,比值比1.79;95%置信区间1.19-2.68)和饮酒习惯(比值比1.64;95%置信区间1.06-2.53)呈正相关,而高剂量他汀类药物(与低剂量相比,比值比0.6;95%置信区间0.40-0.90)和每日服药片数较多(比值比0.93;95%置信区间0.88-0.97)与急性缺血性中风后自我报告的他汀类药物良好依从性呈负相关。然而,中风严重程度和高脂血症诊断与依从性无关。这些结果表明,教育和激励干预可能会提高他汀类药物的依从性,因为可改变的因素与他汀类药物依从性相关。