Assessment of adherence to nootropic medications in neurological patients. (APRIORI study)

Objective. To identify factors that neurologists consider determinants of adherence to nootropic medications in patients with neurological disorders. Material and methods. This cross-sectional descriptive study included 122 neurologists from St. Petersburg and the Leningrad Region. Participants completed a treatment adherence (TA) questionnaire comprising 30 statements divided into four domains: disease-related, patient-related, physician-related, and medication-related factors. Respondents rated their agreement with each statement using a 5-point Likert scale. The most significant statement in each category was identified. Results. The key factors negatively influencing adherence to nootropic medications were the chronic nature of the disease (χ2=8.40; p=0.14), exposure to negative information about the physician online (χ2=17.03; p=0.004), and the requirement for multiple daily doses (χ2=25.03; p=0.0009). In contrast, advanced age was associated with improved adherence to nootropic therapy (χ2=47.27; p=0.0014). Conclusion. Neurologists identified the requirement for multiple daily dosing as a primary contributor to low adherence to nootropic therapy. This barrier may be mitigated by prescribing nootropics with prolonged-release formulations that permit once-daily administration. Other barriers, such as the chronic course of the disease and patient age, are non-modifiable, whereas negative information about the physician online is challenging to address.