Study of the physician recommendation adherence in patients after stroke. The role of anxiety and depression (registry LIS-2)

Abstract

Aim. To assess the adherence to physician recommendations and to study its relation to the post stroke anxiety and depression after stroke. Material and methods. The study was done on the basis of patients hospitalized with the diagnosis of stroke/transient ischemic attack to Lubertsy district hospital No 2 during 2009-2011. In 2,8 (2,1; 3,5) years after discharge we requested patients' life status. The examination was performed, questionnaire of adherence developed in SSRCPM, that include Moricky-Greene test (MGT), short in-hospital anxiety scale HADS. Results. Totally 960 patients included, of those 370 replied to adherence questions, 360 (37,5%) men and 600 (62,5%) women, mean age 71,1±9,8 years (25-99 y.). In hospital 207 (21,6%) died, 753 (78,4%) were discharged for outpatient care. We successed to know the life status of 688 (91,4%) patients, and failed with 65 (8,6%). After discharge from the hospital 237 (31,5%) persons died, refused to be examined 77 (10,2%), 374 (49,7%) were examined, of those 370 agreed to fill in questionnaire. By the HADS score depression was found in 256 (69%), anxiety in 171 (46,2%). By the MGT adherent were only 49 (13,2%), not enough adherent 61 (16,5%), non-adherent 229 (61,9%). We found statistic relation of adhrence parameter existence and value (χ2=8,93; p=0,003), the same relation was found for the anxiety and adherence (χ2=6,29; p=0,01). Depression is highly probable (about 2 times) increased the chance to have low adherence parameters (OR=2,035; 95% CI 1,272-3,254). Anxiety spectrum disorders increased the chance to be non-adherent in about 2 times too (OR=1,775; 95% CI 1,131-2,784). Conclusion. We revealed a high prevalence of depression and anxiety in patients after MI that can negatively affect adherence to physician recommendations.