Medication Adherence and Secondary Stroke Prevention
Summary
Medication adherence is a cornerstone of secondary prevention in stroke survivors, aiming to reduce recurrence, disability and mortality. Effective regimens typically combine antithrombotic, antihypertensive and lipid-lowering agents, often alongside glycaemic control in diabetic patients. Yet adherence remains suboptimal worldwide, influenced by patient beliefs, cognitive status, socioeconomic factors and healthcare system barriers. Poor adherence contributes not only to higher risk of recurrent ischaemic events but also to increased hospitalisations and healthcare costs. Interventions to enhance adherence range from education and counselling to digital reminders and multidisciplinary care pathways. Recognising the interplay between perceptual drivers (such as understanding of treatment necessity) and practical constraints (such as polypharmacy and access to care) is essential for designing tailored, sustainable strategies. Growing evidence underscores that combining behavioural theory with technological platforms, supported by robust predictive analytics, offers promising avenues to improve outcomes across diverse populations.
Research from Nature Portfolio
Recent trials have evaluated digital adherence platforms integrated into routine follow-up. In one randomised study, a smartphone-based reminder system coupled with remote monitoring led to a significant rise in medication possession ratios and a reduction in 12-month stroke recurrence compared with standard care. A large population cohort analysis employing machine-learning algorithms on linked health records has identified key predictors of non-adherence, notably socioeconomic deprivation and post-stroke cognitive impairment, informing stratified risk-mitigation approaches. Furthermore, a comprehensive meta-analysis of digital and pharmacist-led interventions demonstrated that combining automated reminders with personalised counselling yields the greatest improvements in long-term adherence and vascular event reduction, emphasising the value of hybrid models that integrate human support with digital tools.
Medication Adherence and Secondary Stroke Prevention publication trend
The graph below shows the total number of articles in medication adherence and secondary stroke prevention across all publications each year (not limited to Nature Index journals).
Technical terms
Medication adherence: The extent to which patients take medications as prescribed in terms of dose, timing and frequency.
Secondary prevention: Strategies employed after an initial stroke to prevent recurrence and reduce associated morbidity and mortality.
Antithrombotic medications: Drugs, including antiplatelet and anticoagulant agents, that inhibit clot formation to lower stroke risk.
Health Belief Model: A behavioural framework positing that individuals’ health actions are driven by perceived risks, benefits, barriers and self-efficacy.
Patient activation: The degree to which individuals possess knowledge, skills and confidence to manage their own health and treatment.
References
- Effects of a Planned Web-Based Educational Intervention Based on the Health Belief Model for Patients With Ischemic Stroke in Promoting Secondary Prevention During the COVID-19 Lockdown in China: Quasi-Experimental Study. JMIR mHealth and uHealth (2024).
- Treatment Adherence and Secondary Prevention of Ischemic Stroke Among Discharged Patients Using Mobile Phone- and WeChat-Based Improvement Services: Cohort Study. JMIR mHealth and uHealth (2020).
- Antithrombotics prescription and adherence among stroke survivors: A systematic review and meta‐analysis. Brain and Behavior (2022).
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