[A study on drug compliance in secondary prevention of ischemic stroke].

OBJECTIVE: The aim of the present study is to determine the rate of compliance with secondary stroke prevention one year after ischemic stroke and to identify the reasons for poor compliance. METHODS: The proportion of patients compliant with prevention of risk factors (hypertension, diabetes, hyperlipidemia) was evaluated through structured telephone interviews. RESULTS: Of the consecutive patients admitted to the neurological department of Tiantan Hospital between Oct. 2002 and Apr. 2003, 374 patients were involved in this investigation and 296 (79.1%) were finally evaluated. In the 296 (79.1%) patients, the rate of antithrombotic drug compliance was 35.1%. Of the patients with hypertension, diabetes, and hyperlipidemia, 77.9%, 80.2%, and 48.4% were still treated for their respective risk factors. Influence factors for drug compliance, such as medical insurance and free medical care (OR 2.117, 95% CI 1.174-3.821) can promote the drug compliance in stroke patients, while the use of antithrombotic drugs other than aspirin (OR 0.352, 95% CI 0.153-0.812) and a lower living ability (62.5 +/- 13.3) (Mann-Whitney-P = 0.000) could decrease the drug compliance. CONCLUSIONS: Long-term compliance with secondary prevention in patients with ischemic stroke is poor in the setting of our study. Poor compliance with antithrombotic therapy such as incorrect discontinuation or change and reduction of dosage was noted. Means of payment, income levels, categories of antithrombotic drugs and personal living ability of patients are associated with compliance. Doctors should attach importance to secondary prevention and provide stroke patients detailed guidelines for the use of preventive drugs.