Evidence mapPaperPMID 36843040Full record

SynthesisJournal of neurology2023

Impacts of medication non-adherence to major modifiable stroke-related diseases on stroke prevention and mortality: a meta-analysis.

Okti Ratna Mafruhah, Yen-Ming Huang, Hsiang-Wen Lin

Erratum issuedOpen access · hybridAbstract readMeta-AnalysisReview
In one paragraph

Synthesis in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
4.0field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Effects of Undernutrition and Obesity on Functional and Nutritional Outcomes After Ischaemic Stroke: A Hospital-Based Study.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Article
  4. Neighborhood socio-demographic profile associated with adequate transitions of stroke care: The transitions of care stroke disparities study.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
    Observational
  5. Article
  6. Untreated and uncontrolled hypertension in Japanese patients with spontaneous intracerebral hemorrhage.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 3 countries.

Okti Ratna MafruhahSchool of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung City, 406040, Taiwan.
Yen-Ming HuangGraduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei City, 100025, Taiwan. yenming927@ntu.edu.tw.ORCID https://orcid.org/0000-0001-8673-2269
Hsiang-Wen LinSchool of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung City, 406040, Taiwan. hsiangwl@gmail.com.ORCID http://orcid.org/0000-0002-6771-6746
China Medical University · TWNational Taiwan University · TW

Funding

China Medical University Hospital (TW) CMU108-Z-07China Medical University Hospital (TW) CMU109-MF-40China Medical University Hospital (TW) CMU109-Z-07China Medical University Hospital (TW) CMU110-Z-07China Medical University Hospital (TW) DMR-110-080China Medical University Hospital (TW) DMR-112-064Drug Development Center, China Medical University Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) TaiwanMinistry of Science and Technology, Taiwan 108-2911-I-039-301Ministry of Science and Technology, Taiwan 109-2320-B-039-023Ministry of Science and Technology, Taiwan 109-2622-8-039-001-TB1Ministry of Science and Technology, Taiwan MOST 110-2622-8-039-004 -TB1
6 · The paper itself

Abstract

backgroundMedication adherence is one of the crucial attempts in primary stroke prevention. The available evidence lacks comprehensive reviews exploring the association of medication adherence with stroke prevention.

objectivesTo investigate the effects of non-adherence to medications used to treat the modifiable risk of diseases on stroke-associated outcomes in primary stroke prevention.

methodsStudy records were searched from PubMed, Embase, and CINAHL. Those studies reported risks relevant to stroke-associated outcomes and medication non-adherence for patients diagnosed with four modifiable stroke-related diseases (atrial fibrillation [AF], hyperlipidemia, hypertension, and type 2 diabetes mellitus) but without stroke history were included for meta-analysis and further subgroup, sensitivity, and publication bias analyses. A random effect model was performed to analyse the pooled risk estimates of relative risk (RR) and 95% confidence intervals (CIs).

resultsThirty-nine studies (with 2,117,789 participants in total) designed as cohort or case-control studies were included. Those patients presenting with four stroke-related diseases and categorised as medication non-adherent tended to result in stroke and/or associated death (all pooled RR ≥ 1 and 95% CI did not include 1). The findings of stratification and sensitivity analysis for each stroke-related disease showed a similar trend. Non-adherent patients with AF were prone to stroke occurrence (RR 1.852; 95% CI 1.583-2.166) but inclined to reduced bleeding (RR 0.894; 95% CI 0.803-0.996). The existence of publication bias warrants further interpretation.

conclusionsNon-adherence to medications for the four stroke-related diseases contributes to the development of stroke and/or mortality in primary stroke prevention. More efforts are needed to improve patients' medication adherence.

Indexed as

Diabetes Mellitus, Type 2HypertensionStrokeCase-Control StudiesHumansMedication AdherenceMedication adherenceModifiable diseasesMortalityStroke occurrenceStroke prevention

Identifiers

PMID36843040
PMCPMC9968645
OpenAlexW4322208187

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.