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Evaluating practical support stroke survivors get with medicines and unmet needs in primary care: a survey
  1. James Jamison1,
  2. Luis Ayerbe2,
  3. Gian Luca Di Tanna2,
  4. Stephen Sutton1,
  5. Jonathan Mant1,
  6. Anna De Simoni2
  1. 1 Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, School of Clinical Medicine, Cambridge, UK
  2. 2 Centre for Primary Care and Public Health, Barts, The London School of Medicine and Dentistry, London, UK
  1. Correspondence to James Jamison; jj285{at}


Objectives To design a questionnaire and use it to explore unmet needs with practical aspects of medicine taking after stroke, predictors of medicine taking and to estimate the proportion of survivors who get support with daily medication taking.

Design Four workshops with stroke survivors and caregivers to design the questionnaire.

A cross-sectional postal questionnaire in primary care.

Setting 18 general practitioner practices in the East of England and London. Questionnaires posted between September 2016 and February 2017.

Participants 1687 stroke survivors living in the community outside institutional long-term care.

Primary outcome measures The proportion of community stroke survivors receiving support from caregivers for practical aspects of medicine taking; the proportion with unmet needs in this respect; the predictors of experiencing unmet needs and missing taking medications.

Results A five-item questionnaire was developed to cover the different aspects of medicine taking. 596/1687 (35%) questionnaires were returned. 56% reported getting help in at least one aspect of taking medication and 11% needing more help. 35% reported missing taking their medicines. Unmet needs were associated with receiving help with medications (OR 5.9, P<0.001), being on a higher number of medications (OR 1.2, P<0.001) and being dependent for activities of daily living (OR 4.9, P=0.001). Missing medication was associated with having unmet needs (OR 5.3, P<0.001), receiving help with medications (OR 2.1, P<0.001), being on a higher number of medicines (OR 1.1, P=0.008) and being older than 70 years (OR 0.6, P=0.006).

Conclusions More than half of patients who replied needed help with taking medication, and 1 in 10 had unmet needs in this regard. Stroke survivors dependent on others have more unmet needs, are more likely to miss medicines and might benefit from focused clinical and research attention. Novel primary care interventions focusing on the practicalities of taking medicines are warranted.

  • Medication Adherence
  • Caregivers
  • Barthel
  • Stroke Medicine

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  • Contributors ADS is the chief investigator, contributed to the study design, data analysis and commented on the manuscript. JJ contributed to the study design, data collection, data analysis and prepared the manuscript for submission. JM and SS are coinvestigators on the study, wrote and commented on the manuscript. LA and GLDT contributed to the data analysis and commented on the manuscript. All authors agreed on the final draft of the submitted manuscript.

  • Funding This study was funded by the RCGP SFB, Ref. SFB 2014–15 ‘Quantifying the support stroke survivors get with daily medication taking: a questionnaire survey’. ADS and LA are funded by NIHR Academic Clinical Lectureships. This article therefore presents independent research funded by NIHR. JJ was supported by a research grant from The Stroke Association and the British Heart Foundation: TSA BHF 2011/01.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study has received ethical approval from Cambridge Central Research Ethics Committee (REC reference: 16/EE/0182) and from the Health Research Authority (IRAS project ID: 170931).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No other data available.

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