The relevance of living supports on antiplatelet adherence and trial participation: The SPS3 trial

Brandy L. Lewis, Lesly A. Pearce, Thalia S. Field, Carole L. White, Oscar R. Benavente

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    Background: While living with others has been associated with improved functional outcome after acute stroke, it is unclear if this affects adherence to stroke prevention measures. Aims: We examined the relationship between living arrangements and adherence to antiplatelet therapy assignment and participation status in an international randomized trial for secondary stroke prevention. Method: Antiplatelet therapy adherence, trial retention outcomes, and baseline characteristics for participants enrolled in the Secondary Prevention of Small Subcortical Strokes study were compared between those who lived alone vs. with others (n=2374). Participant status at end-of-trial was categorized into (1) on assigned antiplatelet, (2) off assigned antiplatelet by participant request, or (3) participant withdrew consent/lost to follow-up. Multivariable multivariate logistic regression was used to identify patient features at entry predictive of participant status at trial end. Results: Living arrangement, alone vs. with other(s), was not significantly associated with participant status. Participants enrolled in the United States/Canada (odds ratio 3·1, confidence intervals 2·0-5·0, vs. Latin America), taking more (7+) prescription medications (odds ratio 1·7, confidence intervals 1·1-2·7, vs. 0-2 medications), and scoring lower on the Stroke Specific Quality of Life scale (odds ratio 1·3, confidence intervals 1·1-1·5, per 10 points) were more likely to withdraw or become lost to follow-up in the study vs. completing the study on assigned antiplatelet therapy. Participants enrolled in the United States/Canada (odds ratio 5·0, confidence intervals 2·4-10·0, vs. Latin America) and taking fewer (0-2) medications (odds ratio 1·9, confidence intervals 1·2-3·1 vs. 3-6 medications) were more likely to request discontinuation of assigned antiplatelet medication vs. completing the study. Conclusion: Living with others was not independently predictive of protocol adherence in this cohort. Number of medications and Stroke Specific Quality of Life scale score may be more indicative of likelihood of trial participation and acceptance of long-term antiplatelet regimen.

    Original languageEnglish (US)
    Pages (from-to)443-448
    Number of pages6
    JournalInternational Journal of Stroke
    Volume9
    Issue number4
    DOIs
    StatePublished - 2014

    Fingerprint

    Stroke
    Odds Ratio
    Confidence Intervals
    Latin America
    Lost to Follow-Up
    Secondary Prevention
    Canada
    Quality of Life
    Prescriptions
    Therapeutics
    Logistic Models

    Keywords

    • Adherence
    • Antiplatelet therapy
    • Clinical trial
    • Living support
    • Retention
    • Stroke

    ASJC Scopus subject areas

    • Neurology
    • Medicine(all)

    Cite this

    The relevance of living supports on antiplatelet adherence and trial participation : The SPS3 trial. / Lewis, Brandy L.; Pearce, Lesly A.; Field, Thalia S.; White, Carole L.; Benavente, Oscar R.

    In: International Journal of Stroke, Vol. 9, No. 4, 2014, p. 443-448.

    Research output: Contribution to journalArticle

    Lewis, Brandy L. ; Pearce, Lesly A. ; Field, Thalia S. ; White, Carole L. ; Benavente, Oscar R. / The relevance of living supports on antiplatelet adherence and trial participation : The SPS3 trial. In: International Journal of Stroke. 2014 ; Vol. 9, No. 4. pp. 443-448.
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    abstract = "Background: While living with others has been associated with improved functional outcome after acute stroke, it is unclear if this affects adherence to stroke prevention measures. Aims: We examined the relationship between living arrangements and adherence to antiplatelet therapy assignment and participation status in an international randomized trial for secondary stroke prevention. Method: Antiplatelet therapy adherence, trial retention outcomes, and baseline characteristics for participants enrolled in the Secondary Prevention of Small Subcortical Strokes study were compared between those who lived alone vs. with others (n=2374). Participant status at end-of-trial was categorized into (1) on assigned antiplatelet, (2) off assigned antiplatelet by participant request, or (3) participant withdrew consent/lost to follow-up. Multivariable multivariate logistic regression was used to identify patient features at entry predictive of participant status at trial end. Results: Living arrangement, alone vs. with other(s), was not significantly associated with participant status. Participants enrolled in the United States/Canada (odds ratio 3·1, confidence intervals 2·0-5·0, vs. Latin America), taking more (7+) prescription medications (odds ratio 1·7, confidence intervals 1·1-2·7, vs. 0-2 medications), and scoring lower on the Stroke Specific Quality of Life scale (odds ratio 1·3, confidence intervals 1·1-1·5, per 10 points) were more likely to withdraw or become lost to follow-up in the study vs. completing the study on assigned antiplatelet therapy. Participants enrolled in the United States/Canada (odds ratio 5·0, confidence intervals 2·4-10·0, vs. Latin America) and taking fewer (0-2) medications (odds ratio 1·9, confidence intervals 1·2-3·1 vs. 3-6 medications) were more likely to request discontinuation of assigned antiplatelet medication vs. completing the study. Conclusion: Living with others was not independently predictive of protocol adherence in this cohort. Number of medications and Stroke Specific Quality of Life scale score may be more indicative of likelihood of trial participation and acceptance of long-term antiplatelet regimen.",
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    AU - Lewis, Brandy L.

    AU - Pearce, Lesly A.

    AU - Field, Thalia S.

    AU - White, Carole L.

    AU - Benavente, Oscar R.

    PY - 2014

    Y1 - 2014

    N2 - Background: While living with others has been associated with improved functional outcome after acute stroke, it is unclear if this affects adherence to stroke prevention measures. Aims: We examined the relationship between living arrangements and adherence to antiplatelet therapy assignment and participation status in an international randomized trial for secondary stroke prevention. Method: Antiplatelet therapy adherence, trial retention outcomes, and baseline characteristics for participants enrolled in the Secondary Prevention of Small Subcortical Strokes study were compared between those who lived alone vs. with others (n=2374). Participant status at end-of-trial was categorized into (1) on assigned antiplatelet, (2) off assigned antiplatelet by participant request, or (3) participant withdrew consent/lost to follow-up. Multivariable multivariate logistic regression was used to identify patient features at entry predictive of participant status at trial end. Results: Living arrangement, alone vs. with other(s), was not significantly associated with participant status. Participants enrolled in the United States/Canada (odds ratio 3·1, confidence intervals 2·0-5·0, vs. Latin America), taking more (7+) prescription medications (odds ratio 1·7, confidence intervals 1·1-2·7, vs. 0-2 medications), and scoring lower on the Stroke Specific Quality of Life scale (odds ratio 1·3, confidence intervals 1·1-1·5, per 10 points) were more likely to withdraw or become lost to follow-up in the study vs. completing the study on assigned antiplatelet therapy. Participants enrolled in the United States/Canada (odds ratio 5·0, confidence intervals 2·4-10·0, vs. Latin America) and taking fewer (0-2) medications (odds ratio 1·9, confidence intervals 1·2-3·1 vs. 3-6 medications) were more likely to request discontinuation of assigned antiplatelet medication vs. completing the study. Conclusion: Living with others was not independently predictive of protocol adherence in this cohort. Number of medications and Stroke Specific Quality of Life scale score may be more indicative of likelihood of trial participation and acceptance of long-term antiplatelet regimen.

    AB - Background: While living with others has been associated with improved functional outcome after acute stroke, it is unclear if this affects adherence to stroke prevention measures. Aims: We examined the relationship between living arrangements and adherence to antiplatelet therapy assignment and participation status in an international randomized trial for secondary stroke prevention. Method: Antiplatelet therapy adherence, trial retention outcomes, and baseline characteristics for participants enrolled in the Secondary Prevention of Small Subcortical Strokes study were compared between those who lived alone vs. with others (n=2374). Participant status at end-of-trial was categorized into (1) on assigned antiplatelet, (2) off assigned antiplatelet by participant request, or (3) participant withdrew consent/lost to follow-up. Multivariable multivariate logistic regression was used to identify patient features at entry predictive of participant status at trial end. Results: Living arrangement, alone vs. with other(s), was not significantly associated with participant status. Participants enrolled in the United States/Canada (odds ratio 3·1, confidence intervals 2·0-5·0, vs. Latin America), taking more (7+) prescription medications (odds ratio 1·7, confidence intervals 1·1-2·7, vs. 0-2 medications), and scoring lower on the Stroke Specific Quality of Life scale (odds ratio 1·3, confidence intervals 1·1-1·5, per 10 points) were more likely to withdraw or become lost to follow-up in the study vs. completing the study on assigned antiplatelet therapy. Participants enrolled in the United States/Canada (odds ratio 5·0, confidence intervals 2·4-10·0, vs. Latin America) and taking fewer (0-2) medications (odds ratio 1·9, confidence intervals 1·2-3·1 vs. 3-6 medications) were more likely to request discontinuation of assigned antiplatelet medication vs. completing the study. Conclusion: Living with others was not independently predictive of protocol adherence in this cohort. Number of medications and Stroke Specific Quality of Life scale score may be more indicative of likelihood of trial participation and acceptance of long-term antiplatelet regimen.

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    KW - Retention

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