Medications Adherence and Associated Factors Among Patients with Stroke in Iraq

Iman A Basheti,1 Shahnaz M Ayasrah,2 Sadeq AL-Fayyadh,3 Fuad H Abuadas,4 Hana Mohammad Abu-Snieneh,5 Ghufran Emad Bachi6 1Pharmaceutical Sciences Department, Faculty of Pharmacy, Jadara University, Irbid, Jordan; 2Department of Applied Science/Nursing, Al-Balqa Applied University, Al-Salt, Jordan; 3College of Nursing, University of Baghdad, Baghdad, 10071, Iraq; 4College of Nursing, Community Health Nursing Department, Jouf University, Sakaka, 72388, Saudi Arabia; 5Faculty of Nursing, The University of Jordan, Amman, Jordan; 6Al-Muthanah Health Directorate, Al-Muthanah, IraqCorrespondence: Iman A Basheti, Pharmaceutical Sciences Department, Faculty of Pharmacy, Jadara University, Irbid, Jordan, Email [email protected]: Stroke poses significant challenges to affected individuals, their families, and healthcare systems, with adherence to medications being a pivotal determinant of health outcomes. In this study, we aim to evaluate the medication adherence of stroke patients living in Iraq, and explore how patients’ demographic and clinical details relate to their adherence levels. Furthermore, we seek to assess the self-care practices used by stroke patients and their adherence to them.Patients and Methods: We carried out a cross-sectional correlational study conducted from November 2022 to April 2023, stroke patients diagnosed in seven hospitals across Baghdad and Al-Mothanna governorate were recruited, with diagnoses confirmed by physicians and senior neurologists using MRI and/or CT scans. Patients’ adherence to medications, demographic data, clinical characteristics, and self-care activities were analyzed using descriptive statistics and regression analyses.Results: Of the 200 participants, mean age was 58.27 years, with males constituting 53.5%. About 40.5% had a hemorrhagic stroke, and 59.5% an ischemic stroke. The mean adherence score was 13.36 (SD= 4.658) out of a possible 28. Factors significantly correlated with medication adherence included age, monthly income, time since having a stroke, and education level. Adherence was also significantly linked to having diabetes mellitus or high blood pressure. The assessment of participants’ self-care activities and medication adherence revealed that responses to questions about healthcare habits varied, with “None” being the most common response for most items. Notably, we found no significant association between adherence and factors such as gender, marital status, living place, and smoking status.Conclusion: Medication adherence remains suboptimal among stroke patients in Iraq. Various demographic and clinical factors play a role in influencing adherence. The conformity to medication regimens and factors associated with it among individuals who have suffered a stroke in Iraq is vital.Keywords: stroke, medication adherence, self-care activities, demographics, Iraq