Abstract
Adherence to long-term medication is one of the most important components of effective therapy. Many factors have a substantial influence on medication adherence; a special role among them is played by cognitive impairment (CI). Objective : to identify whether poststroke patients have pre-stroke cognitive deficit and to assess its impact on adherence to long-term medication. Patients and methods . A total of 103 patients with acute ischemic stroke in the carotid system were examined. The mean age of the patients was 64.18±10.24 years. The Montreal Cognitive Assessment (MoCA) was applied to assess cognitive functions; the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) was used to determine the presence of pre-stroke cognitive decline. Data concerning vascular risk factors were collected for all the patients. Medication adherence was retrospectively evaluated using the Morisky–Green scale. Results and discussion . Our study showed that only 44.7% of patients were adherent to long-term medication before the stroke. Patients who were engaged in manual labor during their lives were significantly more poorly compliant. Chronic heart failure was also responsible for a reduction in medication adherence. Pre-stroke cognitive deficit was present in 53.4% of the examinees. Unlike patients with normal cognitive function, the majority of patients with pre-stroke CI were non-adherent to medication (28.1 and 71.9%, respectively). At the same time, the adherence to long-term medication depended on the severity of cognitive deficit. Conclusion . The results of the investigation suggest that CI has a considerable impact on adherence to long-term therapy. To improve primary stroke prevention, cognitive functions should be evaluated in all patients with vascular diseases who receive long-term drug treatment. When CI is identified, there is a need for targeted drug treatment and its proper monitoring.
Highlights
Приверженность длительной терапии – один из наиболее важных компонентов эффективной терапии
Many factors have a substantial influence on medication adherence; a special role among them is played by cognitive impairment (CI)
Data concerning vascular risk factors were collected for all the patients
Summary
Цель исследования – определить у пациентов, перенесших инсульт, наличие доинсультного когнитивного дефицита и его влияние на приверженность длительной терапии. Результаты исследования свидетельствуют о том, что КН оказывают значительное влияние на приверженность длительной терапии. Objective: to identify whether poststroke patients have pre-stroke cognitive deficit and to assess its impact on adherence to long-term medication. Поскольку наличие сосудистых заболеваний может усугублять когнитивную дисфункцию, а больные с КН хуже следуют врачебным рекомендациям, можно сделать вывод: многие пациенты еще до развития инсульта имеют низкую приверженность терапии. Цель исследования – оценить у пациентов, перенесших инсульт, наличие доинсультного когнитивного дефицита и его влияние на приверженность длительной терапии. Приверженность терапии определяли ретроспективно с помощь шкалы Мориски–Грина (Morisky Medication Adherence Scale): 4 балла – полностью приверженный лечению пациент и 0 – полностью не приверженный.
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