Medication adherence early after stroke: using the Perceptions and Practicalities Framework to explore stroke survivors', informal carers' and nurses' experiences of barriers and solutions.
Medication adherence early after stroke: using the Perceptions and Practicalities Framework to explore stroke survivors', informal carers' and nurses' experiences of barriers and solutions.
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卒中后早期药物依从性：使用感知和实践框架探索卒中幸存者、非正式护理人员和护士的障碍和解决方案经验。
DOI：
10.1177/1744987121993505
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Watkins C
中科院分区：
文献类型：
--
作者：
Gibson J;Coupe J;Watkins C
卒中后二级预防药物治疗可降低复发风险，但依从性往往较差。中风幸存者、护理人员和护士对中风后早期药物依从性的看法尚未得到探索。本研究旨在探讨脑卒中患者、照护者及护士对脑卒中出院后早期坚持服药的看法及经验。定性个人和小组访谈，利用感知和实用性框架，被采用。9名中风后不到2个月的患者，3名护理人员和15名来自英国卒中单位的护士参与了研究。采访以数字方式记录、转录并进行主题分析。有四个主题和两个副主题。(1)卒中后用药认知。影响依从性的因素包括抑郁、难以察觉的益处和对不良反应的担忧。(2)对药物依从性差高危人群的认知。护士建议，较差的依从性可能更可能出现在那些独居或以前没有依从性的人身上。(3)卒中后早期用药的可行性；这些包括中风后的残疾、认知、多种药物和缺乏信息。（4a）解决住院期间服药依从性差问题的可行性。解决方案包括多学科协调，但护士和中风幸存者描述了不太理想的利用机会来促进依从性。（4b）解决出院后服药依从性差的可行性。解决方案包括修改和护理人员的支持，但中风幸存者报告说，在发展服药系统方面存在困难。中风幸存者和非正式护理人员缺乏出院后早期用药管理所需的知识和支持。护士促进药物依从性的机会没有得到充分利用。需要药物依从性策略来支持出院后早期中风幸存者。
Secondary prevention medication after stroke reduces risk of recurrence, but adherence is often poor. Stroke survivors’, carers’ and nurses’ perspectives of early post-stroke medication adherence are unexplored. The aim of this study was to explore stroke survivors’, carers’ and nurses’ views and experiences about adhering to medication early after post-stroke hospital discharge. Qualitative individual and group interviews, utilising the Perceptions and Practicalities Framework, were employed. Nine people <2 months post-stroke, three carers and 15 nurses from one UK stroke unit participated. Interviews were digitally recorded, transcribed and thematically analysed. There were four main themes with two sub-themes. (1) Perceptions of medication taking after stroke. Factors affecting adherence included depression, imperceptible benefits and concerns about adverse effects. (2) Perceptions about those at higher risk of poor medication adherence. Nurses suggested that poor adherence might be more likely in those living alone or with previous non-adherence. (3) Practicalities of taking medication early after stroke; these included post-stroke disabilities, cognition, polypharmacy and lack of information. (4a) Practicalities of addressing poor medication adherence during the hospital stay. Solutions included multidisciplinary co-ordination, but nurses and stroke survivors described suboptimal use of opportunities to promote adherence. (4b) Practicalities of addressing poor medication adherence post-discharge. Solutions included modifications and support from carers, but stroke survivors reported difficulties in evolving systems for taking medications. Stroke survivors and informal carers lack knowledge and support needed to manage medication early after discharge. Nurses’ opportunities to promote medication adherence are under-exploited. Medication adherence strategies to support stroke survivors early after discharge are needed.
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影响因子：
2.9
作者：
Kvarnstrom, Kirsi;Airaksinen, Marja;Liira, Helena
通讯作者：
Liira, Helena
中风后患者的药物坚持率和与坚持相关的因素：一项队列研究。
影响因子：
2.6
作者：
Lummis, Heather L.;Sketris, Ingrid S.;Gubitz, Gordon J.;Joffres, Michel R.;Flowerdew, Gordon J.
通讯作者：
Flowerdew, Gordon J.
影响因子：
2.4
作者：
Bauler, Stephanie;Jacquin-Courtois, Sophie;Janoly-Dumenil, Audrey
通讯作者：
Janoly-Dumenil, Audrey
DOI：
10.1111/ijpp.12104
发表时间：
2014-12-01
期刊：
The International journal of pharmacy practice
影响因子：
--
作者：
Souter, Caroline;Kinnear, Anne;Mead, Gillian
通讯作者：
Mead, Gillian
影响因子：
6
作者：
Catarina Santos, A.;Ferro, Jose M.
通讯作者：
Ferro, Jose M.