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Abstract
Objective: Stroke is one of the main causes of disability and death worldwide. Proper compliance with medications is very important; however, the impact of patient activation has not been studied thoroughly in stroke populations, especially in low-resource settings such as Pakistan. This study aimed to determine whether patient activation is a predictor of medication adherence in hypertensive stroke patients.
Methods: A cross-sectional study of 209 stroke patients with hypertension was conducted at a tertiary care hospital in Pakistan. Medication adherence was evaluated using the Hill-Bone Medication Adherence Scale, and patient activation was measured using the Patient Activation Measure (PAM-13). Sociodemographic data were gathered, as well as reliability testing, ANOVA, Pearson correlation, and multiple linear regression, which were included in the analysis.
Results: The participants showed moderate to high medication adherence (mean (SD) Hill-Bone score: 14.82 (5.90), while patient activation was indicated by a bimodal pattern, with clustering at Level 1 (33.5%) and Level 4 (33.0%), and the median activation level was Level 3 (IQR: 1-4). A substantial association between patient activation and medication adherence was not detected (r = 0.0004, p = 0.99). Further analysis through regression showed no predictive relationship (β = -0.007, p = 0.92). Additionally, demographic factors did not play a significant role in either construct.
Conclusion: Patient activation was not a predictor of medication compliance. Family and social support may be more dominant than individual activation in maintaining adherence to exercise.
Keywords: Adherence; activation; hypertension; medication; patient; stroke
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