Ian M. Kronish|Michael A. Diefenbach|Donald Edmondson|L. Alison Phillips|Kezhen Fei|Carol R. Horowitz
Key Barriers to Medication Adherence in Survivors of Strokes and Transient Ischemic Attacks
Columbia University Irving Medical Center|Icahn School of Medicine at Mount Sinai|Columbia University Irving Medical Center|George Washington University|Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai
even though medications greatly reduce risk recurrent stroke medication adherence suboptimal stroke survivorsto identify key barriers medication adherence predominantly lowincome minority group stroke transient ischemic attack tia survivorscrosssectional studysix hundred stroke tia survivors age 40 years old recruited underserved communities new york citymedication adherence measured using 8item morisky medication adherence questionnaire potential barriers adherence assessed using validated instruments logistic regression used test barriers independently associated adherence models additionally controlled age raceethnicity income comorbidityforty percent participants poor selfreported medication adherence unadjusted analyses compared adherent participants nonadherent participants increased concerns medications 26 versus 7 p 0001 low trust personal doctor 42 versus 29 p 0001 problems communicating doctor due language 19 versus 12 p 002 perceived discrimination health system 42 versus 22 p 0001 difficulty accessing health care 16 versus 8 p 0002 inadequate continuity care 27 versus 20 p 005 fully adjusted model increased concerns medications 502 95 ci 276 911 p 0001 perceived discrimination 185 95 ci 118 290 p 0008 remained significant barriersincreased concerns medications related worry disruption longterm effects medication dependence perceived discrimination important barriers medication adherence group interventions reduce medication concerns greatest potential improve medication adherence lowincome stroketia survivors