title: Effects of a health promotion program on medication adherence to antiplatelet therapy among ischemic stroke patients in Hainan Province, China.
abstract: Survivors of ischemic stroke are still at a significant risk for recurrence. Antiplatelet agents are the treatment of first choice for long-term secondary prevention of vascular events. This study aims to assess a health promotion program on medication adherence to antiplatelet therapy among ischemic stroke patients in Hainan province, China. In five hospitals from the intervention group, four highly experienced physicians trained 62 neurologists, who in turn trained 613 stroke patients to improve their awareness and adherence to antiplatelet therapy. Physicians and patients of the control group received usual stroke management programs. After one-year follow-up, the proportion of patients who took the antiplatelet therapy increased significantly in the intervention group, reaching 73.2%, with a pre-post difference between two arms of 22.9% ( P < 0.01). There was also a significant net increase in the proportion of patients with awareness of antiplatelet therapy (24.4%, P < 0.01). Multivariate analysis illustrated health promotion program, higher education, annual household income, insurance, and medical status affected antiplatelet drug use in stroke patients. In conclusion, the health promotion program, based on a train-the-trainer approach, showed positive eﬀects on awareness of and adherence to antiplatelet therapy, which has the potential to be scaled up to other resource-limited areas.
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Qingjie
authors: Q
authors: Su
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Chaoyun
authors: C
authors: Li
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Faqing
authors: F
authors: Long
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Bin
authors: B
authors: Chen
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Zhongqin
authors: Z
authors: Wan
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Yingman
authors: Y
authors: Wu
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Mingming
authors: M
authors: Dai
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Desheng
authors: D
authors: Wang
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Yuhui
authors: Y
authors: Zhang
authors: Department of Neurology, Hainan Provincial Nongken Hospital, Haikou, People's Republic of China.
authors: Bufei
authors: B
authors: Wang
mesh_terms: D000328:Adult; D001364:Awareness; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D002681:China; D004502:Education, Medical, Continuing; D004522:Educational Status; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D007182:Income; D007318:Inservice Training; D007348:Insurance, Health; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D000072141:Neurologists / Q000193:education; D010353:Patient Education as Topic; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D015397:Program Evaluation; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Antiplatelet therapy; adherence; awareness; stroke; train the trainer