Correlation between Degree of Compliance to Antihypertensives with Severity of Stroke

Abstract

Objective: Study was conducted to find out correlation between degree of compliance to antihypertensives with severity of stroke.
 Methods: This correlational study was conducted in department of neurology, Pakistan Institute of Medical Sciences, Islamabad from December 2017 to May 2018. A total of 74 patients with clinically and radiologically confirmed diagnosis of stroke, having history of hypertension, were included in the study. According to the Modified Rankin Scale (MRS), scores were assigned from 0 to 6 in increasing order of severity. Quantitative assessment to drug compliance was calculated via Brief Adherence Rating Scale (BARS). According to BARS, scores were assigned from 1 to 4 in decreasing order of non-compliance or increasing order of compliance. Compliance was defined according to BARS as patients taking more than 76% of their prescribed dosage. Compliance of drug was checked for last 6 months. Data was finally analysed by SPSS v. 20. Appropriate statistical tests were applied.
 Results: Mean age of the stroke patients was 58.8 ± 14.91 years. Total 33 patients i.e. 44.6% were compliant and 41 were noncompliant. Strong negative correlation (r= -0.494, p-value= 0.00008) was found between degree of compliance according to BARS scale and severity of stroke according to MRS. Regression analysis showed R2 value of 0.41 and p-value of 0.0004. Most common cause of drug noncompliance according to patients was improper counselling followed by fear of getting used to medication, forgetting, cost, side effects, and dissatisfaction with treatment. Among other risk fac- tors for stroke, 18.9% had positive history for smoking, 43.2% for hyperlipidaemia, 18.9% for coronary artery disease, and 5.4% for atrial fibrillation.
 Conclusion: Adherence to antihypertensives can help in reducing severity of stroke which will result in better prognosis and reduced morbidity and mortality. Most important factor contributing to noncompliance is lack of awareness regarding disease and importance of antihypertensive medications.