Risk factor control and treatment compliance in the following months after stroke are often poor. We aim to validate a digital platform for smartphones designed to raise awareness in patients about the need to perform healthy lifestyle changes, improve communication with medical staff and increase treatment compliance
Methods:
Farmalarm is an app for smartphones designed to increase stroke awareness by: medication visual alerts and compliance control, chat communication with medical staff, sharing didactic video files, exercise monitoring... Stroke patients discharged home were screened for participation and divided in two groups: to follow the FARMALARM program during 3-4 weeks or standard of care follow-up. We determined risk factor control goals at 90 days in all patients
Results:
During 16 months, from the 457 patients discharged home, 126 (27.6%) were included in the study: Farmalarm n=74; age 57±12, Control n=52, age 59±10. There were no significant differences in baseline characteristics between groups. Patients in Farmalarm group followed the program for 23±6 days after discharge. In Farmalarm group, mean number alarms due to medication intake failure dropped from 68.5% in the first week to 44.6% in the third week (p=0.03). At 90 days, achievement of risk factor control was higher in the FARMALARM group (table). The rate of patients with 4/4 risk factors under control was higher in the FARMALARM group (45.3% Vs 22.5%; p=0.02) (graph) and less patients dropped all medications at 3 months in the Farmalarm group (1.5% Vs 8.16%:p=0.05). A regression model adjusted for age and gender showed that the only variable independently associated with all risk factors under control at 90 days was the use of Farmalarm (OR: 4.7; 95% CI:1.1-6.9;p=0.03).
Conclusion:
In stroke patients discharged home the use of mobile applications to monitor medication compliance and increase stroke awareness is feasible and seems to improve the control of vascular risk factors.