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ABSTRACT: Background and purpose
Stroke exacts an immense toll in sub-Saharan Africa where there are few resources, and stroke prevention research is limited. The aim of this study is to test the feasibility and preliminary efficacy of an m-Health technology-enabled, nurse-guided intervention in improving blood pressure (BP) control among Ghanaian stroke patients within 1 month of symptom onset.Methods
We conducted a 2-arm cluster pilot randomized controlled trial involving 60 recent stroke survivors encountered within a single tertiary medical system in Ghana. Subjects in the intervention arm (n=30) received a Blue-toothed UA-767Plus BT BP device and smartphone for monitoring and reporting BP measurements and medication intake for 3 months compared with standard of care (n=30). Primary outcome measure was systolic BP <140 mm Hg at month 3; secondary outcomes included medication adherence and autonomous self-regulation. Analysis accounting for clustering was made using generalized linear mixed model by intention to treat.Results
Mean±SD age was 55±13 years, 65% male. Systolic BP <140 mm Hg at month 3 was found in 20/30 subjects (66.7%) in the intervention arm versus 14/30 subjects (46.7%) in the control arm (P=0.12). Medication possession ratio scores at month 3 were better in the intervention (0.88±0.40) versus control (0.64±0.45) arm (P=0.03). One subject in control arm died from a recurrent hemorrhagic stroke.Conclusions
It is feasible to conduct an m-Health-based, nurse-guided BP control intervention among recent stroke patients in sub-Saharan Africa. We observed a potential signal of efficacy with the intervention, which will need to be tested in a future large definitive study.Clinical trial registration
URL: https://www.clinicaltrials.gov. Unique identifier: NCT02568137.
SUBMITTER: Sarfo F
PROVIDER: S-EPMC5742065 | biostudies-literature | 2018 Jan
REPOSITORIES: biostudies-literature
Sarfo Fred F Treiber Frank F Gebregziabher Mulugeta M Adamu Sheila S Patel Sachin S Nichols Michelle M Awuah Dominic D Sakyi Asumadu A Adu-Darko Nyantakyi N Singh Arti A Tagge Raelle R Carolyn Jenkins J Ovbiagele Bruce B
Stroke 20171208 1
<h4>Background and purpose</h4>Stroke exacts an immense toll in sub-Saharan Africa where there are few resources, and stroke prevention research is limited. The aim of this study is to test the feasibility and preliminary efficacy of an m-Health technology-enabled, nurse-guided intervention in improving blood pressure (BP) control among Ghanaian stroke patients within 1 month of symptom onset.<h4>Methods</h4>We conducted a 2-arm cluster pilot randomized controlled trial involving 60 recent strok ...[more]