RATIONALE: Stroke is the second-leading cause of death in low- and middle-income countries, but use of evidence-based therapies for stroke prevention in such countries, especially those in Africa, is extremely poor. This study is designed to enhance the implementation and sustainability of secondary stroke-preventive services following hospital discharge. AIM/HYPOTHESIS: The primary study aim is to test whether a Chronic Care Model-based initiative entitled the Tailored Hospital-based Risk reduction to Impede Vascular Events after Stroke (THRIVES) significantly improves blood pressure control after stroke. DESIGN: This prospective triple-blind randomized controlled trial will include a cohort of 400 patients with a recent stroke discharged from four medical care facilities in Nigeria. The culturally sensitive, system-appropriate intervention comprises patient report cards, phone text messaging, an educational video, and coordination of posthospitalization care. STUDY OUTCOMES: The primary outcome is improvement of blood pressure control. Secondary endpoints include control of other stroke risk factors, medication adherence, functional status, and quality of life. We will also perform a cost analysis of THRIVES from the viewpoint of government policy-makers. DISCUSSION: We anticipate that a successful intervention will serve as a scalable model of effective postdischarge chronic blood pressure management for stroke in sub-Saharan Africa and possibly for other symptomatic cardiovascular disease entities in the region.
RCT Entities:
RATIONALE: Stroke is the second-leading cause of death in low- and middle-income countries, but use of evidence-based therapies for stroke prevention in such countries, especially those in Africa, is extremely poor. This study is designed to enhance the implementation and sustainability of secondary stroke-preventive services following hospital discharge. AIM/HYPOTHESIS: The primary study aim is to test whether a Chronic Care Model-based initiative entitled the Tailored Hospital-based Risk reduction to Impede Vascular Events after Stroke (THRIVES) significantly improves blood pressure control after stroke. DESIGN: This prospective triple-blind randomized controlled trial will include a cohort of 400 patients with a recent stroke discharged from four medical care facilities in Nigeria. The culturally sensitive, system-appropriate intervention comprises patient report cards, phone text messaging, an educational video, and coordination of posthospitalization care. STUDY OUTCOMES: The primary outcome is improvement of blood pressure control. Secondary endpoints include control of other stroke risk factors, medication adherence, functional status, and quality of life. We will also perform a cost analysis of THRIVES from the viewpoint of government policy-makers. DISCUSSION: We anticipate that a successful intervention will serve as a scalable model of effective postdischarge chronic blood pressure management for stroke in sub-Saharan Africa and possibly for other symptomatic cardiovascular disease entities in the region.
Authors: Fred Stephen Sarfo; Gloria Kyem; Bruce Ovbiagele; John Akassi; Osei Sarfo-Kantanka; Martin Agyei; Elizabeth Badu; Nathaniel Adusei Mensah Journal: J Stroke Cerebrovasc Dis Date: 2016-09-14 Impact factor: 2.136
Authors: A Ojagbemi; M Owolabi; R Akinyemi; O Arulogun; J Akinyemi; O Akpa; F S Sarfo; E Uvere; R Saulson; S Hurst; B Ovbiagele Journal: Acta Neurol Scand Date: 2017-04-17 Impact factor: 3.209
Authors: Alma J Adler; Nicole Martin; Javier Mariani; Carlos D Tajer; Onikepe O Owolabi; Caroline Free; Norma C Serrano; Juan P Casas; Pablo Perel Journal: Cochrane Database Syst Rev Date: 2017-04-29
Authors: Bernadeta Bridgwood; Kate E Lager; Amit K Mistri; Kamlesh Khunti; Andrew D Wilson; Priya Modi Journal: Cochrane Database Syst Rev Date: 2018-05-07