Medication Self-management Interventions for Persons with Stroke

Lauren Cadel, Stephanie R. Cimino, Glyneva Bradley-Ridout, Sander L. Hitzig, Tejal Patel, Chester H. Ho, Tanya L. Packer, Aisha K. Lofters, Shoshana Hahn-Goldberg, Lisa M. McCarthy, Sara J. T. Guilcher.
 

Abstract
The use of multiple medications is common following a stroke for secondary prevention and management of co-occurring chronic conditions. Given the use of multiple medications post-stroke, optimizing medication self-management for this population is important. The objective of this scoping review was to identify and summarize what has been reported in the literature on interventions related to medication self-management for adults (aged 18+) with stroke.

Introduction
Stroke is one of the leading causes of morbidity and mortality worldwide. Globally in 2019, approximately 12.2 million strokes and 6.6 million stroke-related deaths occurred. Common risk factors for stroke include older age, physical inactivity, consumption of alcohol, poor diet, lower socioeconomic status, and comorbidities such as hypertension, coronary heart disease, diabetes, depression, chronic pain, and atrial fibrillation.

Methods:

This scoping review was our second knowledge synthesis related to medication self-management, as part of a larger research study that aims to develop and evaluate a toolkit for medication self-management for persons with spinal cord injury. The first scoping review examined literature related to medication self-management for persons with spinal cord injury.

Discussion:
This scoping review included 56 articles related to medication self-management for adults with stroke. While there were several studies that incorporated medication adherence into a larger intervention, there were few that specifically targeted medication self-management. There remains an opportunity to better support medication self-management for adults with stroke by comprehensively addressing all areas of self-management, delivering interventions across sectors or in the community to ensure individuals are in an environment where they self-manage, understanding the optimal frequency and duration of interventions while maintaining sustainability, and qualitatively exploring experiences with interventions.

Acknowledgments:
We would like to thank Julia Martyniuk, a librarian at the University of Toronto, who peer reviewed the Ovid MEDLINE search strategy.

Citation: Cadel L, Cimino SR, Bradley-Ridout G, Hitzig SL, Patel T, Ho CH, et al. (2023) Medication self-management interventions for persons with stroke: A scoping review. PLoS ONE 18(5): e0285483. https://doi.org/10.1371/journal.pone.0285483

Editor: Jonathan Bayuo, The Hong Kong Polytechnic University, HONG KONG

Received: December 14, 2022; Accepted: April 25, 2023; Published: May 18, 2023.

Copyright: © 2023 Cadel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its supporting information files (S1 Table and S2 Table).

Funding: The research was supported by the Craig H. Neilsen Foundation Psychosocial Research Studies and Demonstration Projects Grant (#855615). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.