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). Conclusion 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. © 2015 Published by Elsevier B.V.