Cross-Country Comparison of Medication Adherence After Stroke Using Standardised Methods: A Pilot Distributed Network Analysis for INSPIRE-STROKE.
L, L.D., M, F.K., A, C., J, I., C, A.J., M, K.K., M, V.V., M, T.O., D, A.C., & A, C.L. (n.d.). Cross-Country Comparison of Medication Adherence After Stroke Using Standardised Methods: A Pilot Distributed Network Analysis for INSPIRE-STROKE.. International journal of population data science. https://doi.org/10.23889/ijpds.v11i5.3546
L LD, M FK, A C, J I, C AJ, M KK, et al. Cross-Country Comparison of Medication Adherence After Stroke Using Standardised Methods: A Pilot Distributed Network Analysis for INSPIRE-STROKE.. International journal of population data science. doi: 10.23889/ijpds.v11i5.3546
L LD, M FK, A C, et al. Cross-Country Comparison of Medication Adherence After Stroke Using Standardised Methods: A Pilot Distributed Network Analysis for INSPIRE-STROKE.[J]. International journal of population data science. DOI: 10.23889/ijpds.v11i5.3546.
@article{l,
author = {L Dalli L and F Kilkenny M and Chu A and Ilomaki J and A Jackevicius C and K Kapral M and V Vyas M and T Olaiya M and A Cadilhac D and C Livori A},
title = {Cross-Country Comparison of Medication Adherence After Stroke Using Standardised Methods: A Pilot Distributed Network Analysis for INSPIRE-STROKE.},
journal = {International journal of population data science},
doi = {10.23889/ijpds.v11i5.3546},
note = {PMID: 42540761},
}
TY - JOUR AU - L Dalli L AU - F Kilkenny M AU - Chu A AU - Ilomaki J AU - A Jackevicius C AU - K Kapral M AU - V Vyas M AU - T Olaiya M AU - A Cadilhac D AU - C Livori A TI - Cross-Country Comparison of Medication Adherence After Stroke Using Standardised Methods: A Pilot Distributed Network Analysis for INSPIRE-STROKE. T2 - International journal of population data science DO - 10.23889/ijpds.v11i5.3546 AN - PMID:42540761 ER -
BACKGROUND: Post-stroke medication adherence can be assessed using dispensing data; however, variations in methods hinder reliable comparisons across regions. We developed and implemented standardised methods to compare post-stroke medication adherence between countries. METHODS: Australia and Canada, with population-based data and universal healthcare systems, were selected for this INSPIRE-STROKE proof-of-concept distributed network analysis (www.inspire-stroke.bigdatacvd.com). Metadata were shared to harmonise data variables and structure. Patients admitted with incident ischaemic stroke and atrial fibrillation (Victoria, Australia [July 2014-June 2017]; Ontario, Canada; [July 2014-March 2022]), aged 66-105 years, who survived ≥90 days post-discharge were included. The proportion of days covered (PDC) of direct oral anticoagulants (DOACs) was measured from initiation to 1-year post-discharge. Adherence was measured in 8 simulations, using standardised code, to adjust for different PDC measurement parameters from the TEN-SPIDERS framework (www.tenspiders.adherencelab.com). Aggregated outputs were compared between countries. RESULTS: Among 2471 Australians (50% female; 36% aged 85+ years) and 16622 Canadians (51% female; 34% aged 85+ years), 50% and 65% initiated a DOAC within 90 days post-stroke, respectively. Among initiators, median 1-year DOAC PDC was 86.8% (interquartile range [IQR]: 75.9%-92.6%) in Australia vs 96.2% (IQR: 89.6%-98.6%) in Canada. Adjustment for pre-supply, early refills, and switching increased median PDC by +10.3% in Australia and +3.5% in Canada. Further adjustment for in-hospital stays had negligible impacts on PDC in both countries. CONCLUSIONS: Standardised methods were successfully implemented to facilitate cross-country comparisons of post-stroke medication adherence. Use of standardised methods in other countries will enable reliable global surveillance of post-stroke medication adherence.