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Abstract

Background: Medication adherence is crucial for secondary stroke prevention, yet non-adherence remains a significant challenge. This study evaluates adherence patterns, identifies key barriers, and assesses clinical outcomes in post-stroke patients receiving antihypertensive therapy.
Methods: A prospective cohort study was conducted in a single tertiary care center, enrolling 150 post-stroke patients. Adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Barriers to adherence were identified through structured questionnaires. Clinical outcomes, including blood pressure control, recurrent stroke, and cardiovascular events, were recorded over a 12-month follow-up. Statistical analyses included Chi-square tests, logistic regression, and Kaplan-Meier survival analysis.
Results: Only 36% of patients exhibited high adherence, while 32% had moderate and 32% had low adherence. Key barriers included forgetfulness (42%), fear of side effects (28%), and cost-related constraints (25%). Patients with low adherence had a 3.2-fold increased risk of recurrent stroke (p = 0.002). Blood pressure control was achieved in 85% of high-adherence patients versus 29% in the low-adherence group (p < 0.001).
Conclusion: Adherence to antihypertensive therapy remains suboptimal in post-stroke patients, contributing to poor clinical outcomes. Targeted interventions addressing barriers to adherence are essential to enhance secondary stroke prevention and improve patient survival