Abstract
BackgroundOne of the most cost-effective treatments for secondary prevention of stroke and other non-communicable diseases is a long-term medication regimen. However, the complexities of medication adherence extend far beyond individual behavior change, particularly in low- and middle-income countries. The purpose of this study was to examine stakeholder perspectives on barriers to medication adherence for stroke patients in Beijing, China, identifying opportunities to improve care and policy in resource-constrained settings.MethodsWe conducted a qualitative, phenomenological analysis of data obtained from 36 individuals. Participants were patients; caregivers; healthcare providers; and representatives from industry and government, purposively selected to synthesize multiple perspectives on medication management and adherence for stroke secondary prevention in Beijing, China. Data was analyzed by thematic analysis across iterative coding cycles.ResultsFour major themes characterized barriers on medication adherence, across stakeholders and geographies: limitations driven by individual patient knowledge / attitudes; lack of patient-provider interaction time; lack of coordination across the stratified health system; and lack of affordability driven by high overall costs and limited insurance policies.ConclusionsThese barriers to medication management and adherence suggest opportunities for policy reform and local practice changes, particularly for multi-tiered health systems. Findings from this study in Beijing, China could be explored for applicability in other low- and middle-income countries with urban centers serving large geographic regions.
Highlights
One of the most cost-effective treatments for secondary prevention of stroke and other noncommunicable diseases is a long-term medication regimen
This study explored the barriers to secondary prevention medication adherence after stroke, through the perspectives of stakeholders from patient to system level
At each level of socioecological influence, emerging theme(s) characterized the perceived barriers on the ability of patients to adhere to their secondary medication prescription regimens after a stroke, summarized as follows: (1) limitations driven by individual patient knowledge / attitudes; (2) lack of patient-provider interaction time; (3) lack of coordination across the stratified health system; and (4) restrictions on affordability driven
Summary
One of the most cost-effective treatments for secondary prevention of stroke and other noncommunicable diseases is a long-term medication regimen. The complexities of medication adherence extend far beyond individual behavior change, in low- and middle-income countries. Patients must understand the need for the medications prescribed, interact with their provider to obtain initial and follow-up prescriptions, have a plan to continuously pick up or receive the medications, be able to pay for them, remember to take them, and feel motivated to consume their medication at the right time and in the right amounts. For some patients, this process could necessitate involvement of additional family members to obtain the medications or provide reminders. For LMICs, human and financial resource constraints compound these existing challenges [6, 7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
