Post-stroke medication adherence and persistence rates: a meta-analysis of observational studies

Background Following a doctor’s prescribed medication regimen is the key to prevent recurrent stroke and adverse outcomes. Many studies have investigated post-stroke drug adherence and persistence in patients. However, a comprehensive analysis of the data is lacking. Objectives A meta-analysis of published literature was conducted to summarize the ratio of medication adherence and persistence in patients after stroke. Methods Relevant studies were identified by conducting a literature search using PubMed, EMBASE and Web of Science up to April 2019. We also reviewed the reference list of the retrieved articles to identify additional studies. We included observational studies that reported data on patients’ medication adherence or persistence status, or the rate of medication adherence or persistence among patients with stroke could be calculated based on the information provided. Results The overall high medication adherence rate of patients with stroke was 64.1% (95% CI: 57.4%–70.8%), and the persistence rate of patients with stroke was 72.2% (95% CI: 69.1%–75.3%). The highest persistence rate was observed in cohort studies which was 80.1% (95% CI: 76.7%–83.4%). The medication adherence rate was the highest in cases where the rates were assessed through interviews or self-reports (77.7% (95% CI: 71.3%–84.1%)). Conclusions Medication adherence and persistence rates are low in patients after suffering a stroke. Patient medication adherence or persistence and their influencing factors should be considered for the treatment of stroke patients. More detailed disease prevention and management strategies need to be developed for stroke patients with different comorbidities.