Compliance with risk factor modification: early-onset versus late-onset stroke patients.
OBJECTIVE
To study the compliance to risk factor modifications and factors related to it, which may be different between early-onset (15-45 years) and late-onset (>45 years) stroke patients. These issues have not yet been addressed properly.


METHODS
We selected 170 early-onset and 340 late-onset stroke patients from the Asan Stroke Registry. The patients were then followed for 1-5 years (an average of 3.4 years) after the onset of stroke. We used a standardized questionnaire to assess the level of compliance and examine the factors contributing to noncompliance.


RESULTS
Ninety-six early-onset and 160 late-onset patients completed a standardized questionnaire. Early-onset patients were less compliant than late-onset patients in the use of antihypertensive medication (p < 0.01), the cessation of cigarette smoking (p < 0.05) and in regular exercise (p < 0.05). Multivariate analysis showed that factors related to noncompliance in early-onset stroke patients included 'a lack of insurance' (noncompliance with the use of antihypertensive medication) and male gender (noncompliance with participation in regular exercise). Factors related to noncompliance in late-onset stroke patients included a high number of cigarettes consumed before the stroke (noncompliance with the cessation of smoking), the lack of regular exercise and a severe modified Rankin scale (noncompliance with regular exercise).


CONCLUSIONS
Early-onset stroke patients are generally less compliant than late-onset stroke patients and the factors related to noncompliance in these groups are different. Therefore, strategies should be developed for improving patient compliance, based on these differences.
Choi-Kwon
Smi
S
College of Nursing, Seoul National University, Seoul, Republic of Korea.
Kwon
Sun U
SU
Kim
Jong S
JS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000523:psychology*; D011795:Surveys and Questionnaires