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Stroke Patients Often Skip Medication

Failure to Take Pills May Be a Factor in Many Second Strokes
By
WebMD Health News
Reviewed by Louise Chang, MD

Feb. 20, 2008 (New Orleans) -- Hundreds of thousands of stroke patients may be placing themselves at increased risk of another stroke simply by not taking their medication as directed.

In a large study, researchers found that most stroke patients filled a prescription for a drug aimed at preventing a second stroke within three months of leaving the hospital. But by a year later, one-third had stopped taking their pills.

Failure to take medication as directed -- doctor's call it noncompliance -- can have devastating consequences for stroke patients, says researcher Deborah Levine, MD, an assistant professor of medicine at Ohio State University in Columbus.

The study was presented at the American Stroke Association's International Stroke Conference.

Many Patients Fail to Fill Prescriptions

Levine and colleagues studied nearly 6,000 U.S. veterans who were discharged from the hospital after being treated for stroke. Over the next year, the researchers tracked whether the veterans filled prescriptions for three major classes of drugs aimed at preventing another stroke.

The three drug classes studied were diuretics, which lower blood pressure; ACE inhibitors and angiotensin receptor blockers (ARBs), which lower blood pressure; and statins, which lower cholesterol.

The number of filled prescriptions is a well-accepted measure for how many pills a person takes, as it is rare for people to buy medication if they don't plan to take it.

Results showed that over the first 90 days after being discharged, 79% of the vets filled at least one prescription for a drug in one of those three classes.

"By 365 days later, 34% of stroke survivors were using none of the three drug classes," Levine tells WebMD.

Most Second Strokes Preventable

Levine says that up to 80% of recurrent strokes can be prevented with "appropriate risk factor modification," which includes getting blood pressure and cholesterol down to acceptable levels -- the very things these drugs are designed to do.

Philip Gorelick, MD, head of the committee that chose which studies to highlight at the meeting and chief of neurology at the University of Illinois in Chicago, says stroke patients should work with their doctors to understand their optimal blood pressure and blood cholesterol levels.

Gorelick tells WebMD that many patients find that pill-sorting boxes, which have containers for medication for each day of the week, are helpful. They're available at most drug stores.

Also, enlist your spouse or significant other to remind you when to take your pills, and put a schedule on the fridge, he suggests.

Levine says sometimes a harried doctor, rushing off to the next appointment, may fail to write a prescription.

"Stroke victims should always talk to their doctors at discharge about medication to prevent recurrent stroke," she advises.

The American Heart Association estimates that there are about 5.8 million stroke survivors in the U.S.

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