Department of Neurology, St. John's Medical College Hospital, Sarjapura Road, Bengaluru, Karnataka, India.
Neurol India. 2021 Nov-Dec;69(6):1743-1746. doi: 10.4103/0028-3886.333533.
Antiplatelet therapy (APT) is an integral part of secondary stroke prevention. Noncompliance to APT is an important factor in stroke recurrence. In this study, we have evaluated the reasons for noncompliance to APT.
The aim of this study was to identify the various causes of nonadherence to APT in recurrent stroke patients.
The study was conducted in a tertiary care hospital in south India with a huge stroke burden. The study period was from October 2017 to September 2018. A total of 60 consecutive patients of recurrent stroke who were nonadherent to antiplatelet therapy were evaluated for various factors that prevented compliance.
During the 12-month study period among 604 ischemic stroke patients, 128 (21%) had recurrent strokes. Of this 128, 60 (46.8%) were due to discontinuation of APT. The main factor for nonadherence to APT was lack of awareness about the need for lifelong medication (41/60; 68.3%). 10 patients (16.7%) stopped treatment as they opted for alternative therapy and 4 (6.7%) discontinued antiplatelets due to side effects. A small proportion of the patients (3.3%) cited financial constraints and forgetfulness as the issue, while 1.7% had difficulty in finding assistance to administer medicine. 27 (45%) patients had recurrent stroke within 2-15 days of stopping APT.
The main reason for nonadherence to antiplatelet therapy is lack of awareness about the need for lifelong antiplatelet therapy. Stroke patients should be educated about the importance of lifelong antiplatelet therapy to prevent recurrent strokes.
抗血小板治疗（APT）是二级预防中风的重要组成部分。不遵守 APT 是中风复发的重要因素。在这项研究中，我们评估了不遵守 APT 的原因。
本研究旨在确定复发性中风患者不遵守 APT 的各种原因。
这项研究在印度南部的一家三级保健医院进行，该医院中风负担沉重。研究期间为 2017 年 10 月至 2018 年 9 月。共评估了 60 例连续复发性中风且不遵守抗血小板治疗的患者，以确定各种阻止他们遵医的因素。
在 604 例缺血性中风患者的 12 个月研究期间，有 128 例（21%）发生了复发性中风。在这 128 例中，有 60 例（46.8%）是由于停止使用 APT 引起的。不遵守 APT 的主要原因是缺乏对终身服药的认识（41/60；68.3%）。10 例（16.7%）患者因选择替代疗法而停止治疗，4 例（6.7%）因副作用而停止使用抗血小板药物。一小部分患者（3.3%）表示经济困难和健忘是问题所在，而 1.7%的患者在找到帮助他们服药方面有困难。27 例（45%）患者在停止 APT 后 2-15 天内再次发生中风。
不遵守抗血小板治疗的主要原因是缺乏对终身抗血小板治疗必要性的认识。应向中风患者宣传终身抗血小板治疗的重要性，以预防中风复发。
