A randomized controlled trial of medication adherence and management of risk factors for secondary prevention of stroke (MaMoRS) using a smartphone-based application
BACKGROUND: There are little data on the use of smartphone-based applications for medication adherence and risk-factor control for the secondary prevention of stroke in low-and-middle-income countries (LMICs).
AIMS: The aim was to determine whether a smartphone-based app improved medication adherence, risk-factor control, and provided health education to stroke survivors for lifestyle and behavioral modifications.
METHODS: An unblinded, single-center randomized controlled double arm trial with 1:1 allocation among stroke survivors was performed in South India. The primary outcome was medication adherence, with co-primary outcomes of lifestyle and behavioral factors and control of vascular risk factors, at 3 and 6 months.
RESULTS: Among 351 stroke survivors screened, 209 were recruited. The mean (standard deviation (SD)) age of the intervention (n = 105) group was 60 (12) years and that of the control (n = 104) group was 60 (10) years. In the primary outcome, mean medication adherence significantly improved in the intervention group with a between group difference of 0.735 (95% confidence interval (CI) = 0.419 to 1.050), p < 0.001. Being in intervention group (OR = 4.5; 95% CI = 2.3 to 8.9), stroke recurrence (OR = 3.3 (95% CI = 1.9 to 7.8)), and regular physician visits (OR = 2.1; 95% CI = 1.0 to 4.4) were significant predictors of good medication adherence. Considering the co-primary outcomes, compared to the control group, participants in the intervention group had a greater improvement in self-reported healthy diet intake (p = 0.003), intake of fruits (p = 0.005), and were physically more active (p = 0.001). At 6 months, mean fasting blood sugar (p = 0.005) and high-density lipoprotein cholesterol higher (p = 0.024) in the intervention group.
CONCLUSIONS: The use of a mobile app is an effective method to improve medication adherence and risk-factor control in stroke survivors and is feasible in LMICs like India.
DATA ACCESS STATEMENT: Data used during the study are available from the corresponding author on request.
TRIAL REGISTRATION: The study is registered in Clinical Trial Registry of India (CTRI/2022/06/042980).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
International journal of stroke : official journal of the International Stroke Society - (2024) vom: 22. Apr., Seite 17474930241245612 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Babu, Veena [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Revised 22.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1177/17474930241245612 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370231570 |
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| 100 | 1 | |a Babu, Veena |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A randomized controlled trial of medication adherence and management of risk factors for secondary prevention of stroke (MaMoRS) using a smartphone-based application |
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| 500 | |a Date Revised 22.04.2024 | ||
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| 500 | |a Citation Status Publisher | ||
| 520 | |a BACKGROUND: There are little data on the use of smartphone-based applications for medication adherence and risk-factor control for the secondary prevention of stroke in low-and-middle-income countries (LMICs) | ||
| 520 | |a AIMS: The aim was to determine whether a smartphone-based app improved medication adherence, risk-factor control, and provided health education to stroke survivors for lifestyle and behavioral modifications | ||
| 520 | |a METHODS: An unblinded, single-center randomized controlled double arm trial with 1:1 allocation among stroke survivors was performed in South India. The primary outcome was medication adherence, with co-primary outcomes of lifestyle and behavioral factors and control of vascular risk factors, at 3 and 6 months | ||
| 520 | |a RESULTS: Among 351 stroke survivors screened, 209 were recruited. The mean (standard deviation (SD)) age of the intervention (n = 105) group was 60 (12) years and that of the control (n = 104) group was 60 (10) years. In the primary outcome, mean medication adherence significantly improved in the intervention group with a between group difference of 0.735 (95% confidence interval (CI) = 0.419 to 1.050), p < 0.001. Being in intervention group (OR = 4.5; 95% CI = 2.3 to 8.9), stroke recurrence (OR = 3.3 (95% CI = 1.9 to 7.8)), and regular physician visits (OR = 2.1; 95% CI = 1.0 to 4.4) were significant predictors of good medication adherence. Considering the co-primary outcomes, compared to the control group, participants in the intervention group had a greater improvement in self-reported healthy diet intake (p = 0.003), intake of fruits (p = 0.005), and were physically more active (p = 0.001). At 6 months, mean fasting blood sugar (p = 0.005) and high-density lipoprotein cholesterol higher (p = 0.024) in the intervention group | ||
| 520 | |a CONCLUSIONS: The use of a mobile app is an effective method to improve medication adherence and risk-factor control in stroke survivors and is feasible in LMICs like India | ||
| 520 | |a DATA ACCESS STATEMENT: Data used during the study are available from the corresponding author on request | ||
| 520 | |a TRIAL REGISTRATION: The study is registered in Clinical Trial Registry of India (CTRI/2022/06/042980) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Smartphone | |
| 650 | 4 | |a medication adherence | |
| 650 | 4 | |a mobile app | |
| 650 | 4 | |a risk factors | |
| 650 | 4 | |a secondary prevention | |
| 650 | 4 | |a stroke | |
| 700 | 1 | |a Sylaja, P N |e verfasserin |4 aut | |
| 700 | 1 | |a Soman, Biju |e verfasserin |4 aut | |
| 700 | 1 | |a Varma, Ravi Prasad |e verfasserin |4 aut | |
| 700 | 1 | |a Ms, Manju |e verfasserin |4 aut | |
| 700 | 1 | |a Gl, Geethu |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar B, Suresh |e verfasserin |4 aut | |
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