Yoo Sung-Hee, Kim Gye-Gyoung, Kim Sung Reul, Park Man-Seok, Kim Joon-Tae, Choi Kang-Ho, Park Hyun-Young, Yi Sang-Hak, Cha Jae-Kwan, Kim Dae-Hyun, Nah Hyun-Wook
College of Nursing, Chonnam National University, Gwangju, Korea.
College of Nursing, Korea University, Seoul, Korea.
J Clin Nurs. 2023 Jan;32(1-2):58-70. doi: 10.1111/jocn.16472. Epub 2022 Aug 3.
Although the optimal use of prescribed medications for stroke survivors is critical for preventing secondary stroke, longitudinal observations of the natural course of medication persistence and adherence in Korean stroke survivors are rare. Furthermore, studies are needed to identify strong predictors influencing medication adherence and to determine whether these predictors change over time.
To evaluate the longitudinal medication persistence and adherence at 3 months and 1 year after discharge in all stroke patients and to identify predictors of long-term medication adherence in patients who can self-medicate.
A multicentre, prospective, longitudinal descriptive study.
A total of 600 consecutive ischaemic stroke patients were recruited from three stroke centres across Korea, from 1 September, 2017 to 28 February, 2019. Various factors related to medication adherence suggested by the World Health Organisation were investigated through face-to-face interviews at each centre during hospitalisation. Medication persistence and adherence were assessed at 3 months and 1 year after discharge using the eight-item Morisky Medication Adherence Scale through telephone interviews.
Of 537 survivors at 3 months, 526 (98.0%) were persistent and 472 (89.7%) were adherent. Of 493 survivors at 1 year, 477 (96.8%) were persistent and 392 (82.2%) were adherent. Medication belief, income and health literacy were statistically significant predictors of three-month medication adherence, which predicted one-year medication adherence with older age and low income.
Among Korean stroke survivors, three-month and one-year medication persistence and adherence were relatively good. Medication beliefs and three-month medication adherence were important and modifiable factors predicting three-month adherence and one-year adherence, respectively.
To increase long-term adherence to medication, various strategies are needed to improve beliefs about medication, taking into account the patient's age and level of knowledge. These interventions need to be initiated during hospitalisation to form early medication habits after discharge.
尽管为中风幸存者合理使用处方药对于预防二次中风至关重要，但关于韩国中风幸存者药物持续使用和依从性自然病程的纵向观察却很少见。此外，需要开展研究以确定影响药物依从性的有力预测因素，并确定这些预测因素是否随时间变化。
评估所有中风患者出院后3个月和1年的纵向药物持续使用情况和依从性，并确定能够自我给药患者长期药物依从性的预测因素。
一项多中心、前瞻性、纵向描述性研究。
2017年9月1日至2019年2月28日期间，从韩国三个中风中心连续招募了600例缺血性中风患者。在住院期间，通过各中心的面对面访谈，调查了世界卫生组织提出的与药物依从性相关的各种因素。出院后3个月和1年，通过电话访谈使用八项Morisky药物依从性量表评估药物持续使用情况和依从性。
在3个月时的537名幸存者中，526名（98.0%）持续用药，472名（89.7%）依从用药。在1年时的493名幸存者中，477名（96.8%）持续用药，392名（82.2%）依从用药。用药信念、收入和健康素养是三个月药物依从性的统计学显著预测因素，而年龄较大和收入较低则是一年药物依从性的预测因素。
在韩国中风幸存者中，三个月和一年的药物持续使用情况和依从性相对较好。用药信念和三个月药物依从性分别是预测三个月依从性和一年依从性的重要且可改变的因素。
为提高长期药物依从性，需要采取各种策略来改善对药物的信念，同时考虑患者的年龄和知识水平。这些干预措施需要在住院期间启动，以在出院后形成早期用药习惯。
