Persistent use of secondary preventive drugs declines rapidly during the first 2 years after stroke.
OBJECTIVE
To prevent new cardiovascular events after stroke, prescribed preventive drugs should be used continuously. This study measures persistent use of preventive drugs after stroke and identifies factors associated with persistence.


METHODS
A 1-year cohort (21,077 survivors) from Riks-Stroke, the Swedish Stroke Register, was linked to the Swedish Prescribed Drug Register.


RESULTS
The proportion of patients who were persistent users of drugs prescribed at discharge from hospital declined progressively over the first 2 years to reach 74.2% for antihypertensive drugs, 56.1% for statins, 63.7% for antiplatelet drugs, and 45.0% for warfarin. For most drugs, advanced age, comorbidity, good self-perceived health, absence of low mood, acute treatment in a stroke unit, and institutional living at follow-up were independently associated with persistent medication use.


CONCLUSIONS
Persistent secondary prevention treatment declines rapidly during the first 2 years after stroke, particularly for statins and warfarin. Effective interventions to improve persistent secondary prevention after stroke need to be developed.
Glader
Eva-Lotta
EL
Department of Public Health and Clinical Medicine, Umeå University Hospital, Umeå, Sweden. eva-lotta.glader@medicin.umu.se
Sjölander
Maria
M
Eriksson
Marie
M
Lundberg
Michael
M
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007326:Institutionalization / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014859:Warfarin / Q000627:therapeutic use*
D000925:Anticoagulants; D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin