Encouraging Stroke Patients To Take Their Medication

Taking medication as prescribed is crucial for stroke patients to manage their condition and prevent another stroke. However, medication adherence can be challenging, and patients may face barriers such as side effects, complex medication regimens, or difficulty understanding the importance of the prescribed medications. Here, we explore strategies for improving medication adherence in stroke patients, including education, simplifying medication routines, addressing side effects, and involving caregivers or support systems. By implementing these strategies, healthcare providers can empower stroke patients to take control of their health and reduce the risk of recurrent strokes.

The importance of taking medication to prevent a second stroke

A stroke is a disruption in brain function caused by a lack of blood flow to the brain. After experiencing a stroke, an individual has a 25%-35% chance of having another one. This is a serious issue, as the second stroke can be life-threatening. Therefore, it is crucial to take medication as prescribed by a doctor to lower the odds of experiencing another stroke.

Types of medication

The type of medication prescribed depends on the type of stroke experienced. Ischemic strokes, caused by a clot in an artery that supplies blood to the brain, are treated with drugs that prevent blood clots from forming or help break them up. On the other hand, hemorrhagic strokes, caused by bleeding inside the brain due to a ruptured blood vessel, may be treated with medication to control bleeding and lower blood pressure.

Benefits of medication

Taking medication as directed is essential for managing chronic conditions, treating temporary conditions, and improving overall health and well-being. Medication can help manage health conditions and diseases, improve quality of life, and even save lives. For example, statins and cholesterol-lowering medications can lower the risk of serious conditions like heart attack and stroke without any noticeable changes in how you feel.

Strategies for taking medication correctly

It can be challenging to remember to take medication, especially if you take multiple medications. Here are some strategies to help you take your medication correctly:

• Set a schedule: Try to take your medications at the same time every day, such as first thing in the morning or right before bed.
• Use a pill container: Get a weekly medication container with labels for each dose and refill it at the same time each week.
• Use timer caps: Purchase bottle caps with built-in alarms to alert you when it's time to take your medication.
• Make them visible: Keep your medicines in a noticeable place, such as next to your toothbrush, but always out of the reach of children and pets.
• Use an app: Many smart device health apps feature medication alarms and reminders.
• Remember to refill: Set a reminder on your smart device or calendar a few days before you run out of medicine.
• Mail order/home delivery: Many insurance companies offer mail-order or home delivery options for medications.

How to take medication as prescribed

Taking medication as prescribed is a critical part of managing your health, especially after a stroke. Here are some detailed instructions on how to take medication as directed:

Understand the Importance of Medication Adherence

Taking your medication as directed by your doctor is crucial for managing your health effectively. After a stroke, medication can help prevent another stroke, manage underlying conditions, and aid in your recovery.

Know Your Medications

It is important to know the names and dosages of your medications, how they work, and any potential side effects. Make a list of your medications and keep it with you, so you always have it handy. This will help you during medical appointments and in case of emergencies.

Take Medications as Prescribed

Always take your medications exactly as your doctor has instructed. Do not skip doses or change the dosage without consulting your doctor or pharmacist first. If you miss a dose, contact your healthcare provider for guidance.

Stick to a Routine

Establish a daily routine for taking your medications. Taking them at the same time each day, such as during meals or at bedtime, can help you remember to take them consistently. Using a pillbox or medication organiser with compartments labelled for each day of the week can also be helpful.

Keep a Medication Calendar

Mark your calendar when your prescription needs to be refilled or when it runs out. Ensure you schedule an appointment with your doctor before your prescription ends to avoid running out of medication.

Avoid Mixing Medications

Do not mix prescription medications with over-the-counter drugs or herbal supplements without consulting your doctor or pharmacist. Certain combinations can be dangerous and interfere with the effectiveness of your prescribed medications. Inform your doctor about any other medications or supplements you are taking.

Communicate with Your Healthcare Team

If you have any questions or concerns about your medications, do not hesitate to contact your doctor or pharmacist. Report any side effects, potential drug interactions, or if you forget to take a dose. They are there to help you and ensure your medication regimen is safe and effective.

The side effects of medication and how to manage them

After a stroke, patients may experience a range of side effects from the medication they are prescribed. The medication prescribed depends on the type of stroke experienced and the patient's overall health.

Diuretics

Diuretics, also known as water pills, can cause a decrease in potassium levels, leading to weakness, leg cramps, and fatigue. Eating foods high in potassium, such as bananas, spinach, and sweet potatoes, can help prevent these symptoms. Doctors may also recommend taking a potassium supplement.

Anticoagulants

Anticoagulants, such as warfarin, dabigatran, and heparin, can increase the risk of bleeding. Patients taking these medications should inform their doctor if they have a bleeding disorder or have experienced excessive bleeding in the past. Consistency is also important when eating vitamin K-rich foods such as cauliflower, broccoli, and leafy greens, as these can affect the effectiveness of the drug.

Antiplatelets

Like anticoagulants, antiplatelet medications, including aspirin, can increase the risk of bleeding and cause problems for those with ulcers.

Antidepressants

Depression and anxiety are common after a stroke, and doctors may prescribe selective serotonin reuptake inhibitors (SSRIs) such as citalopram, fluoxetine, paroxetine, or sertraline to help manage these conditions.

Central Pain Drugs

Central pain after a stroke can be managed with amitriptyline, an antidepressant, or lamotrigine, an anti-seizure drug.

Muscle Spasm Drugs

Botulinum toxin (Botox) injections or pills to relieve spasms and cramping may be prescribed to manage muscle movements that the patient cannot control.

The risks of medication non-adherence

Medication non-adherence is a serious issue that can have detrimental effects on patients' health and well-being, as well as significant economic implications. It is estimated that non-adherence to medication causes around 100,000 deaths and $100 billion in medical costs each year in the US alone. This issue is particularly prevalent among adults taking long-term medications, with approximately 30-50% of US adults not adhering to their prescriptions.

The consequences of medication non-adherence can be severe and include:

• Worsening of the disease: Non-adherence can lead to a substantial worsening of the patient's condition, increasing the risk of a second stroke. After a stroke, patients often need to take medication to control high blood pressure, prevent blood clots, and manage other risk factors to lower the odds of having another stroke. Not taking these medications as prescribed can increase the chances of a recurrent stroke.
• Death: In some cases, medication non-adherence can even lead to death. This is especially true for patients with serious conditions such as stroke, where proper medication management is crucial for recovery and preventing further complications.
• Increased healthcare costs: Non-adherence results in increased use of medical resources, including hospital visits and admissions, nursing home care, and emergency hospitalizations. This not only impacts the patient financially but also contributes to the overall burden on the healthcare system.
• Disease progression and reduced functional abilities: Non-adherence can lead to the progression of the underlying disease and a decrease in the patient's functional abilities. This can result in a lower quality of life and the need for additional medical interventions.
• Antibiotic resistance: In some cases, medication non-adherence can contribute to the development of antibiotic resistance, making it more difficult to treat certain infections effectively.

It is important to note that the risks of medication non-adherence are not limited to the patient but also extend to the healthcare provider, physician, and medical researchers. Additionally, non-adherence can be a complex issue influenced by various factors such as patient views, illness characteristics, social contexts, and access to healthcare services. Effective communication between patients and healthcare professionals is crucial in identifying and addressing barriers to medication adherence.

The role of medication in stroke recovery

Medication plays a crucial role in stroke recovery, and there are several kinds of medications that doctors may administer or prescribe to a stroke patient. The specific medication prescribed depends on the type of stroke, the patient's medical history, and their risk factors. Here is an overview of the role of medication in stroke recovery:

Thrombolytic Drugs (tPA)

Thrombolytic drugs, such as tissue plasminogen activator (tPA), are often referred to as "clot busters." This medication is used to treat ischemic strokes caused by blood clots blocking blood flow to the brain. tPA breaks up these blood clots and must be administered as soon as possible, typically within 3 to 4.5 hours of the onset of stroke symptoms. It can reduce the severity of a stroke and aid in quicker recovery. However, tPA cannot be used for everyone, and certain conditions, such as taking blood thinners or recent surgery, may disqualify its use.

Blood Thinners

Blood thinners, also known as antiplatelet drugs and anticoagulants, are crucial in stroke prevention and treatment. They work by preventing blood clots from forming or growing larger. Antiplatelet drugs, such as ASA (acetylsalicylic acid, Aspirin), clopidogrel, dipyridamole, and ticlopidine, help prevent platelets from sticking together and forming blood clots. On the other hand, anticoagulants like heparin and warfarin interfere with the blood clotting process, making it harder for clots to form or slowing their growth. These medications are often prescribed for people with atrial fibrillation, an irregular heartbeat that increases the risk of blood clots.

Blood Pressure-Lowering Medications

High blood pressure is a leading cause of both ischemic and hemorrhagic strokes. Blood pressure-lowering medications, also known as antihypertensives, are crucial in reducing the risk of stroke and managing blood pressure. Common types of blood pressure drugs include diuretics, ACE inhibitors, beta-blockers, calcium channel blockers, and angiotensin II receptor blockers. These medications work in different ways to relax and widen blood vessels, slow the heart rate, and improve blood flow.

Cholesterol-Lowering Medications

High cholesterol levels can contribute to plaque buildup in arteries, increasing the risk of stroke. Cholesterol-lowering medications, such as statins, block the enzyme HMG-CoA reductase, which is necessary for cholesterol production. This helps reduce cholesterol levels and the risk of plaque buildup, thereby preventing mini-strokes and heart attacks caused by clogged arteries.

Medications for Post-Stroke Conditions

Stroke recovery can also involve managing various post-stroke conditions. Antidepressants may be prescribed to address depression and anxiety, which are common after a stroke. Additionally, doctors may recommend amitriptyline or lamotrigine to manage central pain, such as burning or aching sensations. Osteoporosis supplements, such as calcium and vitamin D, may be suggested to prevent bone density loss and reduce the risk of osteoporosis following a stroke.

Frequently asked questions