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Chronic Disease Management to Enhance Medication Adherence Trajectories in Long-Term Survivors of Stroke: A

Lachlan L Dalli1, Monique F Kilkenny1,2, Muideen T Olaiya1

  • 1Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.

Pharmacoepidemiology and Drug Safety
|May 4, 2025
PubMed

Insights

Chronic disease management (CDM) claims improved medication adherence trajectories in stroke/TIA survivors. CDM was linked to better adherence patterns for antithrombotic, antihypertensive, and lipid-lowering medications.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Pharmacoeconomics

Background:

  • Medication adherence is crucial for long-term stroke/transient ischaemic attack (TIA) survivors.
  • Chronic disease management (CDM) programs aim to improve outcomes but their effect on specific medication adherence patterns post-stroke/TIA is not well understood.

Purpose of the Study:

  • To evaluate the population effect of receiving a chronic disease management (CDM) claim on medication adherence trajectories.
  • To analyze adherence patterns for antithrombotic, antihypertensive, and lipid-lowering medications in long-term stroke/TIA survivors.

Main Methods:

  • A cohort study utilized observational data from the PRECISE registry linked with medication dispensing and primary care claims.
  • Group-based trajectory models assessed medication adherence (antihypertensive, antithrombotic, lipid-lowering) between 19-30 months post-stroke/TIA.
  • Inverse probability treatment weights were used to estimate average treatment effects.

Main Results:

  • Four adherence patterns were identified: near-perfect, high, declining, and non-use.
  • CDM claims were associated with increased near-perfect adherence for antithrombotic medications (OR: 1.16).
  • CDM claims promoted high adherence for antihypertensive (OR: 1.33) and lipid-lowering (OR: 1.26) medications, while reducing non-use.

Conclusions:

  • Chronic disease management (CDM) claims are associated with favorable medication adherence trajectories in long-term stroke/TIA survivors.
  • CDM appears to support sustained adherence to essential cardiovascular medications, potentially improving secondary prevention.
Abstract

Keywords:
data linkagemedication adherencepharmacoepidemiologyprimary carestroke

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