PP316 Efficacy And Usability Of eHealth Technologies In Stroke Survivors For Improvement Of Self-Management: Clinical Trial

2020 ◽  
Vol 36 (S1) ◽  
pp. 28-28
Author(s):  
Eunate Arana Arri ◽  
Leire Ortiz-Fernández ◽  
Janire Orcajo ◽  
Rubén García Fernández ◽  
Joana Sagastagoya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Decision Support ◽  
Conventional Treatment ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Stroke Survivors ◽  
Patient Profile ◽  
System Usability Scale

IntroductionStroke is a leading cause of severe and long-term disability in developed countries. Around 15 million people suffer a stroke each year, most due to modifiable risk factors. Several reviews have shown that interventions mediating eHealth technologies can reduce the risk of suffering a stroke episode, improving the control of risk factors; nevertheless, all of them conclude that new and well-designed studies are needed.MethodsWe performed a prospective, randomized, parallel group and open, pilot trial. The study was carried out based on an initial sample of forty-three patients between 18 and 80 years old who have had an ischemic stroke. The control group got conventional treatment and the intervention group got conventional treatment and the assistance of STARR (the Decision SupporT and self-mAnagement system for stRoke survivoRs), as well as commercial wearables. The principal variable of the study was to evaluate the usability of the decision support system.ResultsAt month nine, the average score on the System Usability Scale in the intervention group was 64.7 and in month 12, 67.4, exceeding in both cases the margin of acceptability (50) and in the limit of “good” (68). When we analyzed clinical factors (systolic/diastolic blood pressure) as well as the analytical parameters related to prevention of reinfarction, we observed that the intervention group had good control of blood pressure and better analytical parameters, compared to the control group.ConclusionsTechnological support allowed participants to feel comfortable using the devices as well as resolving technical incidences by themselves after a training period. The self-management platform can be efficient in stroke survivors’ management of their disease condition, improving analytical and clinical parameters, which eventually can influence a decrease in associated comorbidities and, therefore, improvement of the disease. However, it should be noted that this type of platform is not useful for every patient profile, and studies in this regard should be expanded.

Effect of Dietary Education on Cardiovascular risk Factors in Rheumatoid Arthritis Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Rahil Taheri ◽  
Shahram Molavynejad ◽  
Parvin Abedi ◽  
Elham Rajaei ◽  
Mohammad Hosein Haghighizadeh
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Statistical Tests ◽  
Intervention Group ◽  
Serum Levels ◽  
Control Group ◽  
Dietary Education

Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Method: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after intervention. Data was analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group. Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.

scholarly journals The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomised Controlled Trial

2019 ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Repeated Measures ◽  
Patient Adherence ◽  
Intervention Group ◽  
Public Hospitals ◽  
Self Management ◽  
Control Group ◽  
Management Application

Abstract Background : Self-management of blood pressure is of great significance given the increasing incidence of hypertension and associated disabilities. With the increased use of mobile health in medicine, the present study evaluated the effect of the self-management application on patient adherence to hypertension treatment. Methods : This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up to 24 th weeks. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model). Results : The treatment adherence score increased by an average of 5.9 (95%CI: 5.0-6.7) in the intervention group compared to the control group. Scores of adherence to the low-fat and low-salt diet plans were 1.7 (95%CI: 1.3-2.1) and 1.5 (95%CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95%CI: 61.7-138.3) per week in the intervention group. Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones , mhealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries. Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on 1 January 2016.

scholarly journals The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Repeated Measures ◽  
Patient Adherence ◽  
Intervention Group ◽  
Public Hospitals ◽  
Self Management ◽  
Control Group ◽  
Management Application

Abstract Background: Self-management of hypertension is of great significance given its increasing incidence and its associated disabilities. In view of the increased use of mobile health in medicine, the present study evaluated the effect of a self-management application on patient adherence to hypertension treatment.Methods: This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up until the 24th week. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model).Results: The treatment adherence score increased by an average of 5.9 (95% CI: 5.0-6.7) in the intervention group compared to the control group. Scores of 'adherence to the low-fat and low-salt diet plans' were 1.7 (95% CI: 1.3-2.1) and 1.5 (95% CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95% CI: 61.7-138.3) per week in the intervention group.Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones, mHealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries.Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on January 1st 2016.

scholarly journals The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Repeated Measures ◽  
Patient Adherence ◽  
Intervention Group ◽  
Public Hospitals ◽  
Self Management ◽  
Control Group ◽  
Management Application

Abstract Background: Self-management of hypertension is of great significance given its increasing incidence and its associated disabilities. In view of the increased use of mobile health in medicine, the present study evaluated the effect of a self-management application on patient adherence to hypertension treatment. Methods: This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up until the 24th week. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model). Results: The treatment adherence score increased by an average of 5.9 (95% CI: 5.0-6.7) in the intervention group compared to the control group. Scores of 'adherence to the low-fat and low-salt diet plans' were 1.7 (95% CI: 1.3-2.1) and 1.5 (95% CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95% CI: 61.7-138.3) per week in the intervention group. Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones, mHealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries. Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on January 1st 2016.

scholarly journals The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Repeated Measures ◽  
Patient Adherence ◽  
Intervention Group ◽  
Public Hospitals ◽  
Self Management ◽  
Control Group ◽  
Management Application

Abstract Background: Self-management of hypertension is of great significance given its increasing incidence and its associated disabilities. With the increased use of mobile health in medicine, the present study evaluated the effect of a self-management application on patient adherence to hypertension treatment. Methods: This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up until the24th week. Data on the primary outcome (adherence to treatment) and secondary outcomes(adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model). Results: The treatment adherence score increased by an average of 5.9 (95% CI: 5.0-6.7) in the intervention group compared to the control group. Scores of 'adherence to the low-fat and low-salt diet plans' were 1.7 (95% CI: 1.3-2.1) and 1.5 (95% CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95% CI: 61.7-138.3) per week in the intervention group. Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones, mHealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries. Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on January 1st2016.

ICARUSS: An effective model for risk factor management in stroke survivors

2019 ◽  
Vol 15 (4) ◽  
pp. 438-453 ◽  
Author(s):  
Jacques Joubert ◽  
Stephen M Davis ◽  
Geoffrey A Donnan ◽  
Christopher Levi ◽  
Graeme Gonzales ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Risk Factor ◽  
Primary Care Physicians ◽  
Best Practice ◽  
Intervention Group ◽  
Control Group ◽  
Stroke Survivors ◽  
Risk Factor Management ◽  
Practice Recommendations

Background and purpose After an initial stroke, the risk of recurrent stroke is high. Models that implement best-practice recommendations for risk factor management in stroke survivors to prevent stroke recurrence remain elusive. We examined a model which focuses on vascular risk factor management to prevent stroke recurrence in survivors returning to their primary care physicians. This model is coordinated from the stroke unit, integrates specialist stroke services with primary care physicians, and directly involves patients and carers in risk factor management. It is underpinned by the shared care principle in which there is joint participation of specialists as well as primary care physicians in a planned, integrated delivery of care with ongoing involvement of patients and carers, a structure which encourages implementation of best-practice recommendations as well as transferability and sustainability. We hypothesized that an integrated, multimodal intervention based on a shared-care model which supports joint participation of stroke specialists and primary care physicians would improve the implementation of best-practice recommendations for risk factor management in stroke survivors returning to the community. Methods We undertook a double-blind randomized controlled trial, testing the model in three Australian cities using stroke survivors admitted to stroke units and discharged from hospital to return to their primary care physicians. The model was a shared care, multifaceted integrated program which included bidirectional feedback between general practitioner and specialist unit, education, and engagement of patient and carer in self-management with ongoing input from a multidisciplinary team. The primary endpoint was improvement or abolition of risk factors such as raised blood pressure, diabetes, hyperlipidemia, the modification of adverse life-style factors such as lack of exercise, smoking and alcohol abuse and adherence to preventive medication at one year. Intermediate measurement points were scheduled at three monthly intervals. Analysis was by intention to treat, evaluated by covariance or a linear model adjusting for confounding factors or variance of base-line risk factors. The study was registered as ACTRN = 1261100026498. Results The study population was as follows: intervention ( n = 112), control ( n = 137). At baseline, there was no statistical difference between the groups for any variable. At the 12-month evaluation, there was a significant decrease in systolic blood pressure from baseline in the intervention group of 5.2 mmHg ( p < 0.01). This change was not observed in the control group ( p = 0.29). Moreover, at 12 months the mean systolic blood pressure in the intervention group was 129.4 mmHg (SD 14.7), a result which was not obtained in controls. Fasting total cholesterol as well as triglycerides was reduced significantly in the intervention group (both p < 0.01) but this was not the case in the control group ( p = 0.11 and p = 0.27, respectively). At 12 months, there was no change in BMI in the intervention group but there was a significant increase in BMI ( p = 0.02) in the control group. At 12 months in the intervention group, the mean distance walked with ease compared to the baseline measurements was increased by a mean distance of 600 m while in the control group the distance walked with ease was reduced compared to that measured at baseline. At 12 months, the Barthel index in the intervention group demonstrated improved function ( p = 0.01), but no change was observed in controls. At 12 months in the intervention group, there was a significant decrease in number of standard alcoholic drinks consumed per week compared to the baseline ( p = 0.04). This was not observed in the control group ( p = 0.34). Conclusion In stroke survivors, the ICARUSS (Integrated Care for the Reduction of Secondary Stroke) model is superior to usual care with respect to best-practice recommendations for traditional risk factors as well as behavioral and functional outcomes.

scholarly journals Effectiveness of a Pathway-driven eHealth-based Integrated Care Model (PEICM) for community-based hypertension management in China: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Zheyu Wang ◽  
Chengling Li ◽  
Wencai Huang ◽  
Yan Chen ◽  
Yuqiong Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Integrated Care ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Hypertension Management ◽  
Care Providers ◽  
Care Model ◽  
Community Based ◽  
Management Procedures

Abstract Background: The prevalence of hypertension is high and increasing in China in recent years. The treatment and control of hypertension calls for long-term management beyond hospital, which is hard to implement in traditional care settings. Integrated care combined with information technology can promote high-quality healthcare services across the life-course. However, few studies have applied a customized integrated care model in community-based hypertension management in China, catering to the emerging "three-manager" mode. This study aims to identify the effectiveness of a pathway-driven eHealth-based integrated model that implemented as a full-featured telehealth system to facilitate standardized management of hypertension in China.Methods: The trial has been designed as a one-year, non-blinded superiority trial with two parallel groups. A total of 402 hypertensive patients who meet the eligibility criteria will be recruited and randomized with a 1:1 allocation. All the participants will receive a mobile device for self-management, which is a part of our telehealth system. Participants in the control group will only use the device for BP measurement and receive regular follow-ups from care providers according to the guidelines. Participants in the intervention group will gain full access to the system and receive intervention based on the proposed model (a well-designed coordinated care pathway consisting of 9 tasks). Outcomes will be measured mainly on three occasions (at inclusion, at 6 months and at 12 months). The primary outcome is mean change in systolic blood pressure over a 12-month period. Secondary outcomes include changes in diastolic blood pressure, biochemical indexes related to hypertension, lifestyles, self-management adherence and hypertension awareness, as well as work efficiency of care providers.Discussion: This study aims to determine whether a pathway-driven eHealth-based integrated care model based on the "three-manager" mode will improve hypertension control in China. Success of the model would help improve the quality of present community-based management procedures and benefit more patients with uncontrolled hypertension.Trial registration: Chinese Clinical Trial Registry ChiCTR1900027645, registered on November 22, 2019.

Abstract 59: The Efficacy of a Patient-Centered Self-Management Empowerment Intervention Program for First-Time Stroke Survivors: A Longitudinal Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Lu Chen ◽  
Xiaofang Shen ◽  
Fang Wang ◽  
Lin Lv ◽  
Yan Chen
Keyword(s):  
Quality Of Life ◽  
Intervention Program ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Stroke Survivors ◽  
Patient Centered ◽  
First Time ◽  
Management Behaviors

Keywords: Patient-centered; Self-management; Empowerment; Stroke Purpose: To evaluate the efficacy of a patient-centered self-management empowerment intervention (PCSMEI) program for first-time stroke survivors on self-management behaviors, stroke related depression and quality of life. Methods: One hundred and forty-four first-time stroke survivors were recruited from a comprehensive hospital in China. Patients were randomly allocated into control group (CG: n=72) and intervention group (IG: n=72) after baseline measurement. The intervention group received patient-centered self-management empowerment intervention (PCSMEI) and the control group received a routine care. The data of self-management behaviors, stroke related depression and quality of life were collected at baseline (T0), on discharge (T1), one month post-discharge (T2) and three months post-discharge (T3). Descriptive and Generalized Estimating Equations Modelling (GEE) analyses were conducted to estimate the intervention effect over time. Findings: One hundred and twenty-six participants finished the study (IG: n=64; CG: n=62). Significant improvement in self-management behaviors in the intervention group were observed in stretching or strengthening at T2 and T3; cognitive symptom management at T1, T2 and T3. The depression level was lower in IG than that in CG at T1, T2 and T3. Significant difference in quality of life between the two groups were shown in Physical Component Summary (PCS) at T3 and in Mental Component Summary (MCS) at T2 and T3. Conclusions: The patient-centered self-management empowerment intervention program appears to be an effective and well-received solution to improve first-time stroke patients’ self-management behaviors, stroke related depression and quality of life. Clinical Relevance: This program may be effective for first-time stroke patients.

scholarly journals Effectiveness of a Pathway-driven eHealth-based Integrated Care Model (PEICM) for community-based hypertension management in China: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Zheyu Wang ◽  
Chengling Li ◽  
Wencai Huang ◽  
Yan Chen ◽  
Yuqiong Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Integrated Care ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Hypertension Management ◽  
Care Providers ◽  
Care Model ◽  
Community Based ◽  
Management Procedures

Abstract Background: The prevalence of hypertension is high and increasing in China in recent years. The treatment and control of hypertension calls for long-term management beyond hospital, which is hard to implement in traditional care settings. Integrated care combined with information technology can promote high-quality healthcare services across the life-course. However, few studies have applied a customized integrated care model in community-based hypertension management in China, catering to the emerging "three-manager" mode. This study aims to identify the effectiveness of a pathway-driven eHealth-based integrated model that implemented as a full-featured telehealth system to facilitate standardized management of hypertension in China.Methods: The trial has been designed as a one-year, non-blinded superiority trial with two parallel groups. A total of 402 hypertensive patients who meet the eligibility criteria will be recruited and randomized with a 1:1 allocation. All the participants will receive a mobile device for self-management, which is a part of our telehealth system. Participants in the control group will only use the device for BP measurement and receive regular follow-ups from care providers according to the guidelines. Participants in the intervention group will gain full access to the system and receive intervention based on the proposed model (a well-designed coordinated care pathway consisting of 9 tasks). Outcomes will be measured mainly on three occasions (at inclusion, at 6 months and at 12 months). The primary outcome is mean change in systolic blood pressure over a 12-month period. Secondary outcomes include changes in diastolic blood pressure, biochemical indexes related to hypertension, lifestyles, self-management adherence and hypertension awareness, as well as work efficiency of care providers.Discussion: This study aims to investigate whether a pathway-driven eHealth-based integrated care model based on the "three-manager" mode will improve hypertension control in China. Success of the model would help improve the quality of present community-based management procedures and benefit more patients with uncontrolled hypertension.Trial registration: Chinese Clinical Trial Registry ChiCTR1900027645, registered on November 22, 2019.

scholarly journals The effect of the mobile “blood pressure management application” on hypertension self-management enhancement: a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Repeated Measures ◽  
Patient Adherence ◽  
Intervention Group ◽  
Public Hospitals ◽  
Self Management ◽  
Control Group ◽  
Management Application

Abstract Background Self-management of hypertension is of great significance given its increasing incidence and its associated disabilities. In view of the increased use of mobile health in medicine, the present study evaluated the effect of a self-management application on patient adherence to hypertension treatment. Methods This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed up until the 24th week. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (general linear model). Results The treatment adherence score increased by an average of 5.9 (95% CI 5.0–6.7) in the intervention group compared to the control group. The scores of “adherence to the low-fat and low-salt diet plans” were 1.7 (95% CI 1.3–2.1) and 1.5 (95% CI 1.2–1.9), respectively. Moreover, moderate physical activity increased to 100.0 min (95% CI 61.7–138.3) per week in the intervention group. Conclusion The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones, mHealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries. Trial registration Iran Randomized Clinical Trial Center IRCT2015111712211N2. Registered on 1 January 2016

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