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dc.contributor.authorGynnild, Mari Nordbø
dc.contributor.authorAakerøy, Rachel
dc.contributor.authorSpigset, Olav
dc.contributor.authorAskim, Torunn
dc.contributor.authorBeyer, Mona Kristiansen
dc.contributor.authorIhle-Hansen, Hege
dc.contributor.authorMunthe-Kaas, Ragnhild
dc.contributor.authorKnapskog, Anne Brita
dc.contributor.authorLydersen, Stian
dc.contributor.authorNæss, Halvor
dc.contributor.authorRøsstad, Tove Garåsen
dc.contributor.authorSeljeseth, Yngve Müller
dc.contributor.authorThingstad, Pernille
dc.contributor.authorSaltvedt, Ingvild
dc.contributor.authorEllekjær, Hanne
dc.description.abstractBackground Studies regarding adequacy of secondary stroke prevention are limited. We report medication adherence, risk factor control and factors influencing vascular risk profile following ischaemic stroke. Methods A total of 664 home‐dwelling participants in the Norwegian Cognitive Impairment After Stroke study, a multicenter observational study, were evaluated 3 and 18 months poststroke. We assessed medication adherence by self‐reporting (4‐item Morisky Medication Adherence Scale) and medication persistence (defined as continuation of medication(s) prescribed at discharge), achievement of guideline‐defined targets of blood pressure (BP) (<140/90 mmHg), low‐density lipoprotein cholesterol (LDL‐C) (<2.0 mmol L−1) and haemoglobin A1c (HbA1c) (≤53 mmol mol−1) and determinants of risk factor control. Results At discharge, 97% were prescribed antithrombotics, 88% lipid‐lowering drugs, 68% antihypertensives and 12% antidiabetic drugs. Persistence of users declined to 99%, 88%, 93% and 95%, respectively, at 18 months. After 3 and 18 months, 80% and 73% reported high adherence. After 3 and 18 months, 40.7% and 47.0% gained BP control, 48.4% and 44.6% achieved LDL‐C control, and 69.2% and 69.5% of diabetic patients achieved HbA1c control. Advanced age was associated with increased LDL‐C control (OR 1.03, 95% CI 1.01 to 1.06) and reduced BP control (OR 0.98, 0.96 to 0.99). Women had poorer LDL‐C control (OR 0.60, 0.37 to 0.98). Polypharmacy was associated with increased LDL‐C control (OR 1.29, 1.18 to 1.41) and reduced HbA1c control (OR 0.76, 0.60 to 0.98). Conclusion Risk factor control is suboptimal despite high medication persistence and adherence. Improved understanding of this complex clinical setting is needed for optimization of secondary preventive strategies.en_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internasjonal*
dc.titleVascular risk factor control and adherence to secondary preventive medication after ischaemic strokeen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright 2020 The Authors.en_US
dc.source.journalJournal of Internal Medicineen_US
dc.identifier.citationJournal of Internal Medicine. 2021, 289 (3), 355-368.en_US

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Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal
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