Stroke survivors 'stop taking tablets'

10^th April 2017 -- Researchers say some stroke survivors stop taking medication given to help prevent further strokes, without telling their doctors.

Around 3 out of 10 people go on to have another stroke - which can be fatal.

Medication is usually recommended to help prevent this. This can include statins to lower cholesterol, blood pressure medications and blood thinners. Several different medications may be needed each day, but they can reduce the risk of further strokes by up to 75%. So why don’t people always take their tablets?

Posting concerns

A team including researchers from Queen Mary University of London and the University of Cambridge analysed 21,596 posts over 7 years on the Stroke Association's TalkStroke online forum for survivors and carers.

From the posts, 50 people were found discussing their GP's medication advice.

Side effects of medication was a major conversation topic for people seeing their GP about stroke medication - often about statins. These can make some people feel more tired or achy but the same may not be true of a different type of statin if they change.

The researchers found that some people:

• Talked to their GP about concerns. They were either reassured, having side effects made tolerable, perhaps by changing to different medication, or stayed anxious about their treatment. Some gave up on tablets after one or two consultations.
• Didn’t follow medical advice but admitted not always taking medication or stopping it completely because of side effects.
• Asked other forum members for feedback on the advice they got. Here the researchers found that sharing experience could be useful, especially from forum super-users, with people urged to go back to their doctor or being pointed to other evidence.

Findings

Overall, the researchers write in the journal Family Practice that side effects are a cause of "anxiety and resentment in some patients, and their concerns are not always addressed by practitioners."

They suggest that doctors could do more in a pro-active way to address any concerns to help ensure medication is taken as recommended. This might include follow-up phone calls.

They also say more important information could be obtained in future from looking at forum posts as a way of getting feedback from people who may not take part in traditional medical research methods.

Limitations of the study include the comments being self-reported from people whose identities were not verified, the data being older, from 2004-2011, and older people possibly being less likely to take part in online discussions. The forum was also moderated.