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Researchers focus on secondary stroke prevention after study reveals room for improvement
Date:9/12/2011

uthors noted. "Self-discontinuation of these medications is uncommon."

For the nearly 14 percent of patients who did stop taking their secondary prevention medications on their own, this analysis gave investigators important insight into the reasons why patients self-discontinue.

The researchers learned that several key factors affect "non-adherence," or self-discontinuation. These include whether or not a person has health insurance and can afford their medications, whether the patient receives detailed instructions upon discharge about their medications and understands what the medications do and why taking them is important, whether or not the patient is married to a spouse who can help them remember and motivate them to take their medications, and whether the patient is discharged to his or her home or some other location such as a nursing home or in-patient rehabilitation. These findings represent opportunities for providers and support systems to intervene with the goal of improving medication adherence, Bushnell said.

As a result, Bushnell and colleagues at Wake Forest Baptist are implementing a transition coaching program, which will focus on educating stroke patients about their medications before they are discharged and directly following up with them after discharge to remind them about their doctor's appointments, make recommendations on ways to remember taking their medicine (such as using a daily pill box), answer questions about their condition, treatment and medication, and evaluate them a few weeks after discharge for their risk of rehospitalization.

The factors associated with discontinuing medications reflect the challenges many stroke patients face, Bushnell said. "Not only are many patients disabled and unable to work, but the disability from the stroke also affects medication-taking behavior. Streamlining medication regimens, emphasizing appointment-keeping, helping with insurance applications and referrin
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Contact: Jessica Guenzel
jguenzel@wakehealth.edu
336-716-3487
Wake Forest Baptist Medical Center
Source:Eurekalert

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