Adherence to medication and self-management in stroke patients.

BACKGROUND Stroke is the third most common cause of mortality and one of the leading causes of adult physical disability in England. Medical treatment is imperative for the management of stroke and the risk reduction of recurrent stroke. The success of a medical treatment is determined largely by adherence. However, research has shown that adherence to medication in patients who have had a stroke is often suboptimal. Self-management interventions have been shown to improve adherence in long-term conditions. The impact of self-management interventions specifically on adherence to stroke medication is unknown. OBJECTIVE To review systematically the impact that self-management interventions have on adherence to stroke medication. METHOD The online databases that were systematically searched included PsychINFO, MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews, CINAHL and Web of Science. Reference lists of retrieved studies were hand-searched. RESULTS Six studies met the criteria for inclusion in the systematic review. Self-management interventions for stroke patients were effective in improving adherence to stroke medication in the short term. However, in the longer term, these benefits were not maintained. CONCLUSIONS Applying self-management interventions to improve medication adherence in stroke patients across integrated clinical settings shows promise. However, further development of such interventions and research is recommended, with more stringent methodologies and longer follow-up periods.