A Systematic Review of Randomized Controlled Trials of Medication Adherence Interventions in Adult Stroke Survivors

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Abstract

Background: Stroke survivors are at an increased risk for recurrent stroke. Despite recommendations to avoid recurrence from the American Heart Association/American Stroke Association, medication adherence (MA) in persons with chronic conditions such as stroke is only 50%. Purpose: The aim of this study was to synthesize randomized controlled trial intervention studies designed to increase MA in adult stroke survivors. Search Methods: The Cumulative Index of Nursing and Allied Health Literature, PsycINFO, PubMed, and Excerpta Medica database from January 1, 2009, to December 31, 2015, were searched. Study Selection: This study reviewed randomized controlled trials evaluating MA interventions in stroke survivors. Data Extraction: Two reviewers independently assessed all full-text articles, and those not meeting the inclusion criteria by both researchers were excluded. Results: This review included 18 studies involving 10 292 participants. Overall, the strength of the included studies was strong. Statistically significant results were reported in 5 of the 18 (28%) studies. Of these, 3 used cognitive/behavioral interventions to increase MA, whereas 2 studies used an educational-based intervention. Conclusions: Despite some isolated success, most MA interventions in stroke survivors do not show statistically significant improvement. Future MA research must address the lack of consistent use of objective measurement tools and focus on the long-term benefits of MA interventions.

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