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Int J Stroke. 2014 Dec;9(8):1109-16. doi: 10.1111/ijs.12331. Epub 2014 Jul 18.

Randomized controlled trial of a multipronged intervention to improve blood pressure control among stroke survivors in Nigeria.

Author information

1
Department of Medicine, University of Ibadan, Ibadan, Nigeria.

Abstract

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.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01900756.

KEYWORDS:

Chronic Care Model; hypertension; low- and middle- income countries; patient report card; secondary prevention; stroke

PMID:
25042605
DOI:
10.1111/ijs.12331
[Indexed for MEDLINE]

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