Program to Avoid Cerebrovascular Events through Systematic Electronic Tracking and Tailoring of an Eminent Risk factor: Protocol of a RCT.
Adolescent
Adult
Black or African American
Aged
Aged, 80 and over
Blood Pressure
/ drug effects
Clinical Trials, Phase II as Topic
Clinical Trials, Phase III as Topic
Female
Health Knowledge, Attitudes, Practice
Humans
Hypertension
/ diagnosis
Male
Medication Adherence
Middle Aged
Mobile Applications
Multicenter Studies as Topic
Prospective Studies
Randomized Controlled Trials as Topic
Risk Assessment
Risk Factors
Safety-net Providers
Secondary Prevention
Self Care
Smartphone
South Carolina
Stroke
/ diagnosis
Telemedicine
Time Factors
Treatment Outcome
White People
Young Adult
Hypertension
Mhealth
Risk factor
Secondary prevention
Stroke
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
07
09
2020
revised:
31
03
2021
accepted:
05
04
2021
pubmed:
31
5
2021
medline:
28
7
2021
entrez:
30
5
2021
Statut:
ppublish
Résumé
Geographical and racial disparities in stroke outcomes are especially prominent in the Southeastern United States, which represents a region more heavily burdened with stroke compared to the rest of the country. While stroke is eminently preventable, particularly via blood pressure control, fewer than one third of patients with a stroke have their blood pressure controlled ≥ 75% of the time, and low consistency of blood pressure control is linked to higher stroke risk. To demonstrate that a mHealth technology-centered, integrated approach can effectively improve sustained blood pressure control among stroke patients (half of whom will be Black). The Program to Avoid Cerebrovascular Events through Systematic Electronic Tracking and Tailoring of an Eminent Risk-factor is a prospective randomized controlled trial, which will include a cohort of 200 patients with a stroke, encountered at two major safety net health care systems in South Carolina. The intervention comprises utilization of a Vaica electronic pill tray & blue-toothed UA-767Plus BT blood pressure device and a dedicated app installed on patients' smart phones for automatic relay of data to a central server. Providers will follow care protocols based on expert consensus practice guidelines to address optimal blood pressure management. Primary outcome is systolic blood pressure at 12-months, which is the major modifiable step to stroke event rate reduction. Secondary endpoints include control of other stroke risk factors, medication adherence, functional status, and quality of life. We anticipate that a successful intervention will serve as a scalable model of effective chronic blood pressure management after stroke, to bridge racial and geographic disparities in stroke outcomes in the United States. ClinicalTrials.gov - NCT03401489.
Sections du résumé
BACKGROUND
BACKGROUND
Geographical and racial disparities in stroke outcomes are especially prominent in the Southeastern United States, which represents a region more heavily burdened with stroke compared to the rest of the country. While stroke is eminently preventable, particularly via blood pressure control, fewer than one third of patients with a stroke have their blood pressure controlled ≥ 75% of the time, and low consistency of blood pressure control is linked to higher stroke risk.
OBJECTIVE
OBJECTIVE
To demonstrate that a mHealth technology-centered, integrated approach can effectively improve sustained blood pressure control among stroke patients (half of whom will be Black).
DESIGN
METHODS
The Program to Avoid Cerebrovascular Events through Systematic Electronic Tracking and Tailoring of an Eminent Risk-factor is a prospective randomized controlled trial, which will include a cohort of 200 patients with a stroke, encountered at two major safety net health care systems in South Carolina. The intervention comprises utilization of a Vaica electronic pill tray & blue-toothed UA-767Plus BT blood pressure device and a dedicated app installed on patients' smart phones for automatic relay of data to a central server. Providers will follow care protocols based on expert consensus practice guidelines to address optimal blood pressure management.
STUDY OUTCOMES
RESULTS
Primary outcome is systolic blood pressure at 12-months, which is the major modifiable step to stroke event rate reduction. Secondary endpoints include control of other stroke risk factors, medication adherence, functional status, and quality of life.
DISCUSSION
CONCLUSIONS
We anticipate that a successful intervention will serve as a scalable model of effective chronic blood pressure management after stroke, to bridge racial and geographic disparities in stroke outcomes in the United States.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov - NCT03401489.
Identifiants
pubmed: 34052785
pii: S1052-3057(21)00218-4
doi: 10.1016/j.jstrokecerebrovasdis.2021.105815
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT03401489']
Types de publication
Clinical Trial Protocol
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105815Informations de copyright
Published by Elsevier Inc.