Adherence and
Taking stroke-related medications on time and as directed

Adherence and
How are medication "adherence"
and "compliance" different?
It's important to understand the
difference between medication
adherence and medication compliance.
Medication adherence is the act of
fil ing new prescriptions or refil ing
prescriptions on time. Medication
compliance is the act of taking
medication on schedule or taking
medication as prescribed.
Why are medication adherence and
compliance so important?
According to the National Council on
Patient Information and Education,
"Lack of medication adherence is
America's other drug problem." Poor
medication adherence can lead to:
Unnecessary disease progression and complications Reduced functional abilities and An additional $2,000 per year in medical costs and physician visits Increased use of expensive, specialized medical resources Unneeded medication changes Medication noncompliance can also lead to hospital stays—the average length of stay due to medication noncompliance is 4.2 days. In the United States, 12 percent of people don't take their medication at al after they fil /buy the prescription. Reasons for
Why are non-adherence and
non-compliance so common?
There are a number of reasons why
people do not adhere or comply with
their medication regimen. The chart
below lists common factors that
interfere with medication adherence
and compliance.
Social/economic-related factors

Treatment anxiety Fear of becoming dependent on medication Length of treatment Complexity of treatment Unwanted side effects Level of disability Severity of the condition Improve Medication
Adherence and
Help your healthcare professionals
help you
It is absolutely necessary to help your
healthcare professionals create an
accurate profile of your medication use.
Take an active role and tell your
healthcare professional and pharmacist
about your experiences with your
medications. Be vocal, and don't leave
any information out. Share any
suggestions and/or changes you have,
and be sure to follow up and let them
know how you're feeling after any
changes in medication. Remember—
you are the patient. Healthcare
professionals are there to help you.
Reduce cost barriers
If you can't afford to take your
medication, it doesn't matter how good
that medication is. There are steps you
can take to help reduce the financial
burden. Talk with your pharmacist, and
use generics when available. Also ask
about discount programs and any
Patient Assistance Programs that may
be available from the drug manufacturer.
Ask about value-based insurance design,
which may reduce copays.
Improve Medication
Adherence and
Address your own behaviors
Form good habits
There are good habits you can form
when dealing with your medication.
Make sure that you are informed
about your condition(s) as well as
why you are taking your medication(s).
Be honest about your preferences,
limitations and priorities. Talk with
your healthcare professionals, and
follow up with them with any questions
or concerns you may have.
Stick with one pharmacy
It's important to remember that
medication is not a convenience item—
do not hop from pharmacy to pharmacy.
Instead, form a relationship with one
pharmacy. Get to know the staff and let
the staff get to know you and your
family and/or caregivers.
Make sure that you ask a lot of questions. If your pharmacist does not answer your questions to your satisfaction, then it is time to look elsewhere for your medications.
Also, make sure that your healthcare professional knows where you get your prescriptions filled. Your pharmacist and healthcare professional must work together to ensure safe treatment for you and your condition.
Use tools to help remember medications
There are many helpful tricks and tools
that you can use so that you remember
your medications. Set reminders on your
phone or alarm clock to remind you
when your dose is due. Use pill boxes to
organize your medicines.
Medication trackers—like the one at the
end of this brochure—can be very
useful. Utilize them to write down each
medication you take and how you take
it. Write down how each medication
makes you fell as well. Make sure that
your family and caregivers know and
understand your tracking system so
they are able to explain it to your
healthcare professionals in the event of
an emergency.
With so many stroke-related medications available, remembering each medication and what it does can be confusing. Use the chart below as a reference to help keep your medications straight.
Drug Class
What They Do
Anticoagulants Reduce the risk of
prevent existing blood clots from getting bigger by thinning the blood Prevent platelets (blood cells) from sticking together Persantine®, Ticlid®) Angiotensin II Block angiotensin II, a
chemical that triggers muscle contraction around blood vessels, narrowing them. By inhibiting the chemical, blood vessels can enlarge and blood pressure is reduced.
GABA (gamma-
Inhibit the action Amino butyric
acid) receptor
neurotransmitters and regulates the Affect physiological central nervous
and psychological processes in the central nervous system proteins in nerves to relax muscles Statins (Lipitor®, Lower cholesterol
Crestor®, Zocor®, by inhibiting the
blood that produces cholesterol in the liver Warning Signs of Stroke
Learn the many warning signs of a

stroke. Act fAST and CALL 9-1-1
IMMEDIATELy at any sign of a stroke.
use fAST to remember warning signs:
fACE: Ask the person to
smile. Does one side of the
F face droop?
A ARMS: Ask the person to raise
both arms. Does one arm drift
S SpEECh: Ask the person to
repeat a simple phrase. Is their
speech slurred or strange?
T TIME: If you observe any
of these signs, call 9-1-1
fIRST AppEAR. If given within three
hours of the first symptom, there is an FDA-approved clot-buster medication that may reduce long-term disability for the most common type of stroke.
of STRokE AT
Warning Signs of Stroke
fIRST AppEAR. If given within three
hours of the first symptom, there is an FDA-approved clot-buster medication that may reduce long-term disability for the most common type of stroke.
of STRokE AT
National Stroke Association's mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke. A stroke is a brain attack that occurs when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain. Brain cells begin to die. CAll -1-1 IMMEdIATEly IF

Supported by a contribution from AstraZeneca. All publications are reviewed by National Stroke Association's Publications Committee. 2012 National Stroke Association 2/12 BG13 Taking medications as prescribed is central to recovery post-stroke and recurrent stroke prevention. Tear out this form and bring it to your healthcare professional's office. Use the Medication Tracker on the reverse side to write down each medication you take and how you take it.
Questions to Ask Your Healthcare

What is the medicine's name, what is it for, and what does it look like? When and how do I take this medicine? What are the possible side effects? When should I expect the medicine to start working? What do I do if I forget my dose? What are the repercussions if I stop taking this medicine altogether? Besides time of day, is there anything else I should know about taking my meds (e.g., on a full stomach, with milk, drug interactions, etc.)? ily and caregivers.
edication tracker. List each ith your friends, fam How Medication Makes Me Feel
edications is stay organized w , and share this inform you take it below edication and how


International Journal of Ophthalmology & Eye Science (IJOES) Epidemiology of Eales Disease in the Central Western India Shah MA*, Shah SM, Kalyani PJ, Shah AH, Shah PD, Pandya JS Drashti Netralaya, Dahod, Gujarat, India. Objective: To investigate the clinical features and propose a new staging system based on the clinicopathological correla-

Microsoft word - 3c868221-3714-0574.doc

Thrash, I. & Derry, J.F. (1999) The nature and modelling of piospheres: a review. Koedoe 42(2): 73-94. Pretoria. ISSN 0075-6458. REVIEW OF LITERATURE ON THE NATURE AND MODELLING OF PIOSPHERES I. Thrash and J.F. Derry A piosphere is an ecological system of interactions between a watering point, its surrounding vegetation and the grazing animal. In the simplest case of an isolated watering point in one uniform rangeland type, a gradient of utilisation pressure develops which is greatest near the watering point and decreases as a function of distance from it. Water-dependent herbivores are forced to congregate within a maximum distance of about 10 km from watering points in the dry season. Piosphere patterns are always detected in herbaceous species composition. Range condition, grass production, biomass, understory cover, standing crop and basal cover have also all been found to be directly proportional to distance from water. In areas with large populations of elephants the density and canopy cover of trees is directly proportional to distance from watering points. In the absence of elephants an increase in woody plant density and canopy cover tends to occur in a zone just beyond the sacrifice area. Soil erosion, compaction and capping tend to occur at watering points on soils containing clay and silt. Artificial watering points advantageous to the non-mobile water dependent large herbivore species and disadvantageous to the water independent large herbivore species. While being parsimonious treatments of a complex system, conceptual models do provide a reasonable basis upon which to design an improved understanding. Although the logistic curve is a convenient tool to estimate piosphere dimensions, by adopting the logistic equation and not selecting the 'best-fit' model for a piosphere data set, the loss in estimator precision may outweigh the logistic curve's usefulness. A large number of gradient models have been developed, each an attempt to shed some light on the behavioural response underlying what appears to be a complex grazing pattern. Several system models that take piosphere effects into account have been constructed. Some of these produce good simulations of herbaceous material dynamics and especially good simulations of bush densification. Gaps in our knowledge of piospheres are discussed.