Mobile health intervention can help prevent secondary stroke: study

NEW DELHI: Mobile health the intervention may lead to an improvement in lifestyle behaviors that may prevent secondary hitaccording to a study conducted in India whose results were published in the journal Lancet Global Health.
Mobile health (mHealth) refers to the use of mobile and wireless devices to improve health and provide care. The study was carried out in 31 stroke centers in India and the trial intervention was a package consisting of text messages, health education videos and stroke prevention manuals for patients.
The trial was conducted by SPRINT-India (Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package) under the Indian Stroke Clinical Trial Network (INSTRuCT) of ICMR of stroke ready centers in India, unique in its kind in developing countries and the fourth government-supported network worldwide.
Doctor Meenakshi Sharma Scientist-G, Division of Non-Communicable Diseases, ICMR said that the SPRINT study is the first trial in India (and possibly the world) to attempt to assess the role of an mHealth intervention in secondary prevention strokes on such a large scale.
This was a multicenter, randomized, controlled trial of a semi-interactive mHealth intervention in stroke patients, the ICMR said in a statement.
Messages broadcast on cell phones focused on controlling blood sugar, blood pressure and cholesterol, improving physical activity, healthy eating and taking medication to prevent strokes.
Outreach material was systematically developed in 12 different regional languages.
Patients in the control group received standard care while those in the intervention group received educational materials at weekly intervals to promote healthy living and medication adherence, according to the statement.
A total of 4298 patients were randomly assigned to the intervention arm (2148) and the control arm (2150).
In addition, 1502 patients in the intervention arm and 1536 patients in the control arm completed a one-year follow-up.
The trial used complex behavioral interventions to reduce stroke recurrence, the statement said.
The trial results revealed that a structured semi-interactive stroke prevention package improved behavioral lifestyle factors and medication adherence, which may have long-term benefits.
The trial went further than contemporary trials in assessing the effect on parameters such as recurrence of cardiovascular events and death.
However, the follow-up period was short to show differences between the control and intervention groups. The trial results were published in the journal Lancet Global Health on February 14, 2023.
Dr Jeyaraj D Pandian, Professor of Neurology and Principal, Christian Medical College, Ludhiana, who is the principal investigator at the clinical coordinating center of the trial, said the proportion of patients who quit smoking (83pc) and alcohol (85pc) s improved in the intervention group compared to the control group. group (respectively 78 pc and 75 pc).
Medication adherence was also better in the intervention arm (94 pc) compared to the control arm (89 pc). Events such as strokes, heart attacks and deaths did not differ between the two groups (5.5% vs. 4.9%) at one year follow-up.
This may be because the follow-up period was too short or the study centers were stroke-ready centers, which already provided good quality care to stroke patients.
The results of the SPRINT India trial have a long-term benefit for patients who have suffered a stroke through mobile health interventions.
Dr Meenakshi Sharma said the trial offers hope for improving lifestyle and medical complications by leveraging technology in a resource-limited setting.
In Phase 2 which started in September 2022, four more stroke trials, which are highly relevant to the country, were initiated by ICMR. We would get answers to important treatments for stroke in the years to come.
Stroke (brain attack) is one of the leading causes of death and disability in India. There are two types of stroke; ischemic when there is a blockage in one of the cerebral arteries and cerebral hemorrhage when there is a rupture and leak in one of the arteries that supply blood to the brain, according to the press release.
Arterial hypertension is the leading cause of ischemic and hemorrhagic strokes. High blood sugar, high cholesterol, smoking, obesity, alcohol consumption, lack of exercise and poor diet are the other reasons for stroke.
Moreover, after a stroke, about 15-20% of patients in India develop another stroke (recurrence).
The main reasons for recurrence are discontinuation of medications, lack of control of BP, blood sugar, continued smoking, alcohol consumption, unhealthy eating habits, etc.

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