Predictors of adherence to secondary preventive medication in stroke patients

Ann Behav Med. 2011 Jun;41(3):383-90. doi: 10.1007/s12160-010-9257-6.


Objective: The purpose of this study is to identify factors which predict adherence in stroke survivors.

Design: This is a longitudinal study where 180 stroke survivors were assessed 1 year after their first ischaemic stroke. The relationship between adherence and illness and medication beliefs was tested at baseline (time 1) and again 5-6 weeks later (time 2).

Main outcome measures: The main outcome measures used in this study are Medication Adherence Report Scale and urinary salicylate levels.

Results: Four variables predicted time 1 poor adherence: (1) younger age, (2) increased specific concerns about medications, (3) reduced cognitive functioning and (4) low perceived benefit of medication. Three out of these four variables were again predictive of time 2 adherence and accounted for 24% of the variance: (1) younger age, (2) increased specific concerns about medications and (3) low perceived benefit of medication. The urinary salicylate assay failed to differentiate between patients taking and not taking aspirin.

Conclusion: Interventions to improve adherence should target patients' beliefs about their medication.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / urine
  • Aspirin / therapeutic use
  • Attitude to Health*
  • Brain Ischemia / complications
  • Brain Ischemia / drug therapy
  • Brain Ischemia / prevention & control*
  • Brain Ischemia / psychology
  • Cognition
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Medication Adherence / psychology*
  • Psychiatric Status Rating Scales
  • Salicylates / urine
  • Secondary Prevention
  • Severity of Illness Index
  • Stroke / drug therapy
  • Stroke / prevention & control*
  • Stroke / psychology*
  • Stroke / urine


  • Anti-Inflammatory Agents, Non-Steroidal
  • Salicylates
  • Aspirin