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Predicting Compliance With Treatment Following Stroke: A New Model of Adherence Following Rehabilitation

Published online by Cambridge University Press:  21 February 2012

Nicolene Coetzee ,
David Andrewes ,
Fary Khan ,
Tom Hale ,
Lisanne Jenkins ,
Nadina Lincoln  and
Peter Disler
Nicolene Coetzee
Affiliation:
The University of Melbourne, Australia.
David Andrewes*
Affiliation:
The University of Melbourne, Australia; The Royal Melbourne Hospital, Australia. [email protected]
Fary Khan
Affiliation:
The Royal Melbourne Hospital, Australia.
Tom Hale
Affiliation:
The Royal Melbourne Hospital, Australia.
Lisanne Jenkins
Affiliation:
The University of Melbourne, Australia.
Nadina Lincoln
Affiliation:
Institute of Work, Health and Organisations, University of Nottingham, United Kingdom.
Peter Disler
Affiliation:
Bendigo Hospital, Australia.
*
*Address for correspondence: Associate Professor David Andrewes, School of Behavioural Science, University of Melbourne VIC 3010, Australia.
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Abstract

Background and purpose: Adherence to medication is fundamental to optimal health recovery yet compliance to medication rates are lower than 50% in most studies. This study aimed to investigate the correlates of adherence in stroke patients. Method: Twenty-six stroke patients and 29 amputee patients who had completed a rehabilitation program at Melbourne Rehabilitation Centre were investigated. Medical adherence was determined from computed adherence metrics based on pill counts and subjective reports of patient knowledge of medication use. Model components that were believed to contribute to poor adherence, included emotional and cognitive dysfunction, beliefs about medication, and social support. These factors were assessed by patient and partner self-rating questionnaires. Results: Stroke patients showed a lower level of adherence compared to amputee patients. Cognitive and emotional dysfunction, beliefs about medication, and the level of care were significantly associated with low adherence to medicine regimes in stroke patients. Level of cognitive impairment and emotional impairment were significantly associated with low adherence to medicines in amputee patients. Emotional dysfunction was the best predictor of poor adherence in both patient groups. Conclusion: The findings are in keeping with past adherence studies with other patient groups and support the position that emotional, cognitive, and social factors are important factors in adherence. The specific nonadherence profile for this brain-damaged group is modeled and the application for outpatients following rehabilitation is discussed.

Keywords

adherencecompliancestrokemodel
Type
Articles
Information
Brain Impairment , Volume 9 , Issue 2: SPECIAL ISSUE: Stroke Rehabilitation , 01 September 2008 , pp. 122 - 139
Copyright
Copyright © Cambridge University Press 2008

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