title: Long-term medication persistence in stroke patients treated with intravenous thrombolysis.
abstract: OBJECTIVE
  There are no data regarding long-term medication persistence in stroke survivors treated with intravenous thrombolysis (IVT), which is one of the most important determinants of treatment success. Our objective was to determine long-term medication persistence in stroke patients treated with IVT.
  
  
  METHODS
  This retrospective observational study included 203 IVT-treated and 197 non-IVT treated patients with acute ischemic strokes (IS) admitted to the Stroke Unit between January 2007 and January 2013.
  
  
  RESULTS
  During a median follow-up period of 3 years (range 1-7 years), 56 (21.6%) patients in the IVT-group and 62 (23.9%) patients in the non-IVT-group died. There was a higher medication persistence for all secondary stroke prevention medications (anti-thrombotic agents, anti-hypertensive drugs, statins and hypoglycemic drugs) in the IVT-group compared to the non-IVT group (88.7% vs. 69.0%; OR=3.68, 95% CI=2.17-6.23). After adjusting for baseline characteristics and possible confounders IVT was the independent predictor of medication persistence (OR=2.93, 95% CI=1.48-5.81, p=0.002). Higher medication persistence was observed in patients with favorable long-term functional outcome, both in the IVT-group (OR=4.37, 95% CI=1.83-10.40, p<0.001) and the non-IVT-group (OR=3.46, 95% CI=1.84-6.52, p<0.001).
  
  
  CONCLUSIONS
  Medication persistence was higher among IVT-treated patients compared to non-IVT-treated patients. The higher rate of non- medication persistence was recorded among patients with more pronounced disabilities after stroke.
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Maja Stefanovic
authors.initials: MS
authors.lastname: Budimkic
authors.affiliation: Medical Faculty University of Belgrade, Belgrade, Serbia; Institute of Epidemiology, Belgrade, Serbia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Pekmezovic
authors.affiliation: Medical Faculty University of Belgrade, Belgrade, Serbia.
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Beslac-Bumbasirevic
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia; Medical Faculty University of Belgrade, Belgrade, Serbia.
authors.forename: Marko
authors.initials: M
authors.lastname: Ercegovac
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia; Medical Faculty University of Belgrade, Belgrade, Serbia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Berisavac
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Predrag
authors.initials: P
authors.lastname: Stanarcevic
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Visnja
authors.initials: V
authors.lastname: Padjen
authors.affiliation: Medical Faculty University of Belgrade, Belgrade, Serbia. Electronic address: dejana.r.jovanovic@gmail.com.
authors.forename: Dejana R
authors.initials: DR
authors.lastname: Jovanovic
mesh_terms: D061605:Administration, Intravenous; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000639:trends*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents
keywords: Intravenous thrombolysis; Medication persistence; Stroke outcome