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 Researchers who tracked internet discussion-board conversations
about stroke found that most survivors followed their doctors'
advice but some stopped taking medications due to side effects.
"Family practitioners should make patients aware of multiple
treatment options and the potential need for several changes in
medication, and actively follow-up with their patients when
providing advice or changing treatment due to side effects, such as
aches and tiredness," said senior author Anna De Simoni, of Queen
Mary University of London.
De Simoni and colleagues write in Family Practice that three in 10
stroke survivors will go on to have a second stroke. Medications
that lower blood pressure and cholesterol and thin the blood can
reduce that risk by up to 75 percent.
Past research suggests patients who are prescribed these so-called
secondary prevention medications may have trouble sticking to their
regimens, the authors write.
For the new study, De Simoni's team focused on posts made by 50
participants on the online TalkStroke forum, including 33 stroke
survivors and 17 caregivers of stroke survivors.
Most people reported sticking to doctors' orders, but that wasn't
always the case when people experienced side effects they felt were
due to cholesterol-lowering medications known as statins, for
example. Common side effects of those drugs include fatigue,
headaches and muscle aches and pains.
"When suffering from statin side effects, patients did make contact
with their doctors in the attempt to manage them, but I was
surprised to see that they seemingly lost hope after only one or two
contacts with their family physicians, unaware that a better regimen
may have been available or that their doctor would have been able to
carry out another change in medication," De Simoni told Reuters
Health in an email.
Side effects led to "anxiety and resentment" among patients, who
felt their needs weren't always being addressed by their doctors,
the researchers found.
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"The online dialogue between stroke survivors and carers offers a
deeper understanding of the barriers to persistence with secondary
prevention medications," said De Simoni.
The research team found that people responding to the posts were
generally supportive of doctors' advice, and none of the posts was
incorrect or misleading. "The forum’s ‘super-users’, who had a high
number of connections with other participants, played an important
role" in the quality of the content, said De Simoni.
The researchers warn that secondary stroke prevention has changed
since the last posts analyzed in this study were written in 2011, so
these patients' issues may not reflect what happens in today's
doctors' office. Additionally, the discussion board users were
young; their behavior may not reflect the actions of older stroke
patients.
"These findings indicate the need to raise patients’ awareness of
the existence of several cholesterol lowering treatments and
approaches to manage side effects," said De Simoni.
SOURCE: http://bit.ly/2okfAID Family Practice, online April 10,
2017.
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