. 2023 May 18;18(5):e0285483.

doi: 10.1371/journal.pone.0285483. eCollection 2023.

Medication self-management interventions for persons with stroke: A scoping review

Lauren Cadel^{1

2}, Stephanie R Cimino^{3

4}, Glyneva Bradley-Ridout⁵, Sander L Hitzig^{3

4

6}, Tejal Patel^{7

8}, Chester H Ho⁹, Tanya L Packer^{10

11}, Aisha K Lofters^{12

13}, Shoshana Hahn-Goldberg^{1

14}, Lisa M McCarthy^{1

2}, Sara J T Guilcher^{1

2

3

4

15}

Affiliations

¹ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
² Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
³ Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁴ St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
⁵ Gerstein Science Information Centre, University of Toronto, Toronto, ON, Canada.
⁶ Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁷ University of Waterloo School of Pharmacy, Kitchener, ON, Canada.
⁸ Schlegel-University of Waterloo Research Institute of Aging, Waterloo, ON, Canada.
⁹ Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
¹⁰ Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, NS, Canada.
¹¹ Department of Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands.
¹² Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
¹³ Women's College Research Institute, Toronto, ON, Canada.
¹⁴ OpenLab, University Health Network, Toronto, ON, Canada.
¹⁵ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.

PMID: 37200316
PMCID: PMC10194931
DOI: 10.1371/journal.pone.0285483

Medication self-management interventions for persons with stroke: A scoping review

Lauren Cadel et al. PLoS One. 2023.

. 2023 May 18;18(5):e0285483.

doi: 10.1371/journal.pone.0285483. eCollection 2023.

Authors

Affiliations

¹ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
² Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
³ Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁴ St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
⁵ Gerstein Science Information Centre, University of Toronto, Toronto, ON, Canada.
⁶ Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁷ University of Waterloo School of Pharmacy, Kitchener, ON, Canada.
⁸ Schlegel-University of Waterloo Research Institute of Aging, Waterloo, ON, Canada.
⁹ Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
¹⁰ Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, NS, Canada.
¹¹ Department of Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands.
¹² Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
¹³ Women's College Research Institute, Toronto, ON, Canada.
¹⁴ OpenLab, University Health Network, Toronto, ON, Canada.
¹⁵ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.

PMID: 37200316
PMCID: PMC10194931
DOI: 10.1371/journal.pone.0285483

Abstract

The use of multiple medications is common following a stroke for secondary prevention and management of co-occurring chronic conditions. Given the use of multiple medications post-stroke, optimizing medication self-management for this population is important. The objective of this scoping review was to identify and summarize what has been reported in the literature on interventions related to medication self-management for adults (aged 18+) with stroke. Electronic databases (Ovid Medline, Ovid Embase, EBSCO CINAHL, Ovid PsycINFO, Web of Science) and grey literature were searched to identify relevant articles. For inclusion, articles were required to include an adult population with stroke undergoing an intervention aimed at modifying or improving medication management that incorporated a component of self-management. Two independent reviewers screened the articles for inclusion. Data were extracted and summarized using descriptive content analysis. Of the 56 articles that met the inclusion criteria, the focus of most interventions was on improvement of secondary stroke prevention through risk factor management and lifestyle modifications. The majority of studies included medication self-management as a component of a broader intervention. Most interventions used both face-to-face interactions and technology for delivery. Behavioural outcomes, specifically medication adherence, were the most commonly targeted outcomes across the interventions. However, the majority of interventions did not specifically or holistically target medication self-management. There is an opportunity to better support medication self-management post-stroke by ensuring interventions are delivered across sectors or in the community, developing an understanding of the optimal frequency and duration of delivery, and qualitatively exploring experiences with the interventions to ensure ongoing improvement.

Copyright: © 2023 Cadel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

**Fig 1. PRISMA 2020 flow diagram of included articles.**

See this image and copyright information in PMC

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Fakoori F, Zhou L, Gardener H, Gutierrez C, Asdaghi N, Bishop L, Brown SC, Campo-Bustillo I, Gordon Perue G, Johnson KH, Veledar E, Ying H, Romano JG, Rundek T, Marulanda E; Transitions of Care Stroke Disparities Study (TCSD-S) Investigators. Fakoori F, et al. J Stroke Cerebrovasc Dis. 2025 Jul;34(7):108330. doi: 10.1016/j.jstrokecerebrovasdis.2025.108330. Epub 2025 Apr 26. J Stroke Cerebrovasc Dis. 2025. PMID: 40294726 Free PMC article.

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Medication self-management interventions for persons with stroke: A scoping review

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Medication self-management interventions for persons with stroke: A scoping review

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