Stroke survivors often stop taking life-saving medicines because of side effects: BMJ

One in three people who have had a stroke don’t take their prescription medicine irregularly, which raises their risk of getting a second deadlier stroke that can potentially kill them.

Many people who have had a stroke don’t take their prescription medicine regularly, which raises their risk of getting a second deadlier stroke that can potentially kill them.

Around 30% of stroke patients refuse to take life-saving statins because of worries related to side effects, reports a study in the British Medical Journal Open (BMJ Open), and the situation is not different in India.

"Non-compliance is a big issue for us, especially if the patients get drugs free during treatment and then they don't bother to buy them on their own later," says Dr Daljit Singh, professor, neurosurgery department at the Delhi government-run GB Pant Hospital.

"Some may develop side effects such as muscular weakness but in my experience, compliance increases with the patients’ level of education and socio-economic status," said Dr Singh.

One-third of all strokes occur in people who have previously had a stroke. To prevent this recurrence, patients are offered secondary preventative medications, but 30%-40% patients do not continue medicines as prescribed, with the dose varying from 20 mg to 40 mg once a day.

People who have had a stroke are at risk of a second stroke, which carries a greater risk of disability and death than first-time strokes.

The UK study found that side effects were a major reason why people stopped taking medication, sometimes in consultation with their physician and other times unilaterally.

Other users were concerned about the efficacy of the medications and some believed risk could be managed with lifestyle changes alone.

Perceptions were not the only barriers to adherence, there were often practical problems too. At times, the medicines were too large and difficult to swallow, sometimes the drug regime was too burdensome.

“Doctors need to develop drug regimens and routines and strategies to ensure patients kept to them, but there has been a larger debate going on currently on whether the medicine can be prescribed to all stroke patients as not everyone may benefit from the drug,” said Dr Singh.