Improving adherence to medication in stroke survivors: a pilot randomised controlled trial

Area of Science:

• Neurology
• Behavioral Science
• Clinical Pharmacy

Background:

• Poor adherence to preventive medication is a significant challenge in managing chronic conditions.
• Existing interventions for medication adherence have shown limited success, particularly in stroke survivors.

Purpose of the Study:

• To pilot a randomized controlled trial evaluating a brief, personalized intervention to increase medication adherence in stroke survivors.
• To assess the feasibility and effectiveness of implementation intentions and belief modification for improving adherence.

Main Methods:

• Sixty-two stroke survivors were randomized into an intervention or control group.
• The intervention included two sessions focusing on implementation intentions (linking medication to environmental cues) and addressing mistaken beliefs about medication and stroke.
• Adherence to antihypertensive medication was objectively measured over 3 months using an electronic pill bottle.

Main Results:

• The intervention group demonstrated significantly higher adherence, with 97% of doses taken on schedule compared to 87% in the control group.
• This 10% increase in adherence was statistically significant (p=0.048).
• The results suggest the intervention's effectiveness beyond placebo effects of increased patient contact or measurement.

Conclusions:

• A simple, brief intervention effectively increased medication adherence in stroke survivors.
• The findings support the use of personalized strategies, including implementation intentions and belief modification, to improve adherence to preventive medications.
• This approach holds potential for improving long-term health outcomes in stroke populations.