Three months after suffering a stroke or a transient ischemic attack, sometimes called a mini-stroke, one in four patients sent home with medications prescribed to drive down the risk of a repeat stroke or heart attack aren’t taking those medications, a new study finds.
The medication study, published online Monday in the journal Archives of Neurology, found that in the majority of cases, physicians are discontinuing patients’ medications — for reasons that aren't known. But across all classes of medications prescribed to them, small numbers of patients unilaterally discontinue their medications: As few as 1.5% of patients who are prescribed the blood thinner warfarin quit taking the pills on their own; as many as 4.3% of those prescribed diuretics, which are used to control high blood pressure, stop taking the pills.
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They found that younger patients and those who leave the hospital with the highest numbers of medications, those who suffered the severest disability after their strokes and those without health insurance are more likely to be off their medications three months after a stroke. Older patients who understand why their medications are prescribed, and are either employed or at home voluntarily, are more likely to remain on medication at that point.
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It is not perfectly clear how well medications work to prevent a second event. But there’s early evidence that they can make a difference — if the patient takes those medications.
UCLA researchers were among the first to gauge the impact of aggressive efforts to prevent a second stroke. When stroke patients did not comply with doctors’ orders to stop smoking, exercise, watch their diet and take medications to keep blood pressure, cholesterol or diabetes under control, UCLA researchers in 2008 found they were almost three times as likely as those who had complied to suffer another “event,” such as a stroke or heart attack.
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