Studying issues related to stroke medication non-adherence is essential for secondary prevention of stroke. This study aimed to identify the prevalence of medication non-adherence and risk factors among stroke survivors. The reasons behind this are that some patients may not follow stroke medication plans, and potential ways to help patients adhere better to medication plans.

This study employed a cross-sectional patient survey.

The study was conducted in 20 public and private healthcare facilities in a resource-constrained setting, in Punjab, the largest province of Pakistan.

We included 6538 stroke survivors aged 21–75 years with at least a 6 month history of stroke who were prescribed one or more anti-stroke medications and met the inclusion criteria.

The main outcome was medication non-adherence, measured by the Self-Efficacy for Appropriate Medication Scale (SEAMS) and self-reported pill count. Descriptive statistics were used to summarise study variables. chi-square (²)/Fisher’s exact test and independent t-test/ANOVA were employed. A generalised linear model (logit model using multivariable logistic regression shows that several factors are associated with medication non-adherence and adherence. Odds ratio (OR) plots were generated using Seaborn and Matplotlib.

Non-adherence based on pill counts was 49.7%, while the mean SEAMS score (31.3±7.7) showed moderate self-reported adherence. After adjusting for age, gender, marital status, education, income, health insurance, smoking status, comorbidities, stroke type, disease duration, blood pressure control, number of medications, dosing frequency, physiotherapy continuation, perceived side effects and doctor-patient satisfaction, we found that female gender (vs male: AOR 0.31, 95% CI 0.27 to 0.35), lower income (10k–25k PKR vs >100k PKR: AOR 0.31, 95% CI 0.23 to 0.41; 26k–50k PKR vs >100k PKR: AOR 0.57, 95% CI 0.47 to 0.68), primary/secondary education (vs postgraduate: AOR 0.74, 95% CI 0.64 to 0.87), controlled BP (vs uncontrolled: AOR 0.66, 95% CI 0.59 to 0.73), longer disease duration (≥5 years vs

This study addresses the significant issue of medication non-adherence in stroke patients in Pakistan, reflecting global patterns yet remaining under-explored locally. It emphasises the critical role of adherence in managing chronic conditions such as stroke, where consistent use of preventive therapies is vital for reducing recurrence and improving outcomes. While the non-adherence rates are consistent with global trends, there is a notable lack of observational studies and epidemiological data in the Pakistani context. Our findings support a comprehensive approach to enhance medication adherence, taking into account the complex connections among social, behavioural and clinical factors. It also highlights the importance of maintaining detailed records to monitor adherence trends, identify high-risk groups and inform targeted public health interventions.

In order to prevent chronic kidney disease (CKD), it is crucial to identify temporal trends in CKD incidence at the global level, both past and future.

An observational cross-sectional study.

We retrieved data on annual cases of CKD from the Global Burden of Disease (GBD) online database for the period between 1990 and 2021. To assess the trends in age-standardised incidence rates (ASRs) of CKD, we applied the average annual percentage change (AAPC) for both observed data (1990–2021) and projected data (2022–2030). Bayesian age-period-cohort models were employed to predict CKD ASRs and case numbers through 2030.

From 1990 to 2021, the number of newly diagnosed CKD cases worldwide rose from 7 758 599 (95% CI: 7 721 790 to 7 795 410) to 19 950 853 (95% CI: 19 914 040 to 19 987 670). During that same period, the CKD ASR increased from 145.66 to 252.93 per 100 000 people, with an AAPC of 0.74% (95% CI: 0.73 to 0.75). By 2030, the number of CKD cases is projected to reach 25 057 700 (95% credible interval (CrI: 23 389 630 to 26 725 770), and the ASR is expected to increase to 297.62 per 100 000 (AAPC: 0.15%, 95% CrI: 0.14 to 0.16). The most significant ASR increases are expected among individuals with type two diabetes mellitus (AAPC: 0.17%, 95% CI: 0.01 to 0.34), hypertension (AAPC: 0.17%, 95% CI: 0.05 to 0.28%), older adults (aged ≥60) (AAPC: 0.21%, 95% CI: 0.20 to 0.22) and individuals in middle- (AAPC: 0.19%, 95% CI: 0.11 to 0.27) and high-middle socio-demographic index (SDI) countries (AAPC: 0.18%, 95% CI: 0.09 to 0.27). Of the six WHO regions, the largest increase is predicted to occur in the Western Pacific region by 2030 (AAPC: 0.21%, 95% CrI: 0.11 to 0.32), followed by Eastern Mediterranean (AAPC: 0.18%, 95% CrI: 0.06 to 0.31). Of the 204 countries and territories examined, 201 showed an increasing trend between 1990 and 2030, while only three experienced a decrease.

CKD incidence rates and case numbers are predicted to increase globally through 2030. Women; people with type two diabetes mellitus and hypertension; people over 60 years of age; people living in high, middle and high-middle-SDI countries, as well as those from the region of the USA, Europe and the Western Pacific, are projected to have the highest ASR of CKD in 2030. This highlights the need to consider these subgroups in future plans for global control of CKD.