scholarly journals Correction: Treatment Adherence and Secondary Prevention of Ischemic Stroke Among Discharged Patients Using Mobile Phone- and WeChat-Based Improvement Services: Cohort Study

10.2196/19454 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e19454 ◽  
Author(s):  
Yuanjin Zhang ◽  
Dongsheng Fan ◽  
Hong Ji ◽  
Shudong Qiao ◽  
Xia Li
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Mobile Phone ◽  
Treatment Adherence ◽  
Discharged Patients

scholarly journals Treatment Adherence and Secondary Prevention of Ischemic Stroke Among Discharged Patients Using Mobile Phone- and WeChat-Based Improvement Services: Cohort Study

10.2196/16496 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e16496 ◽  
Author(s):  
Yuanjin Zhang ◽  
Dongsheng Fan ◽  
Hong Ji ◽  
Shudong Qiao ◽  
Xia Li
Keyword(s):  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Event Rate ◽  
Influencing Factor ◽  
Community Based ◽  
Traditional Group ◽  
Self Monitoring ◽  
Endpoint Event ◽  
Discharged Patients

Background Real-world studies have indicated that adherence is important for guaranteeing medication effectiveness. Few studies have tested the feasibility and efficacy of WeChat-based improvement services, via mobile phone, in secondary prevention-specific follow-up among discharged stroke patients. Objective We evaluated a quadruple-domain, WeChat-based service for ischemic stroke secondary prevention designed to improve treatment adherence of discharged patients. This service focuses on sending reminders for drug use, blood pressure recording, and glucose recording; it also records medication use. We compared the endpoint event rate between WeChat self-monitoring and traditional monitoring. Methods A cohort study was used to determine the feasibility of a physician-assisted, WeChat-based improvement service and follow-up self-monitoring platform for the secondary prevention of ischemic stroke. The platform was developed by the Peking University Third Hospital based on the information-motivation-behavioral skills model. The overall adherence rate was calculated as the proportion of medication doses verified via uploading. The ischemic endpoint event rate and medication noncompliance rate were compared between traditional prevention monitoring and WeChat self-monitoring. Factors influencing adherence were summarized. Results The 1-year follow-up event rate of the WeChat self-monitoring group was 11.9% (12/101), which was less than that of the traditional group (21/157, 13.4%). Compared with the traditional group, the risk ratio of the WeChat group was 0.983 (95% CI 0.895-1.080); this difference was not noted to be significant. The 1-year medication noncompliance ratio tended to be lower in the WeChat monitoring group (3/101, 3.0%) than in the traditional group (11/157, 7.0%; χ2=1.9, df=1, P=.16). Of the platform registry participants, 89.7% (210/234: 167 hospital-based and 43 community-based participants) adhered to inputting information into WeChat for 8-96 weeks. The average adherence time was 16.54 (SD 0.80, range 2-24) months. The average decrease in adherence was 4 participants (1.1%) per month. Being a member of a community-based population was an influencing factor for good adherence at the 2-year follow-up (OR 2.373, 95% CI 1.019-5.527, P=.045), whereas transient ischemic attack was an influencing factor for poor adherence at the 2-year follow-up (OR 0.122, 95% CI 0.016-0.940, P=.04). Conclusions Use of WeChat self-monitoring showed a trend of increasing medication compliance and decreasing ischemic endpoint event rate compared with traditional monitoring. However, there were ceiling effects in the outcomes, and a relatively small sample size was used. Male participants displayed better adherence to WeChat self-monitoring. The community-based population displayed good adherence when using WeChat self-monitoring. Trial Registration ClinicalTrials.gov NCT02618265; https://clinicaltrials.gov/ct2/show/NCT02618265

Epidemiology and secondary prevention of ischemic stroke in patients on antiplatelet drug: a retrospective cohort study

2019 ◽  
Vol 48 (2) ◽  
pp. 336-344 ◽  
Author(s):  
Andrea Gallo ◽  
Silvia Galliazzo ◽  
Stefano Grazioli ◽  
Luigina Guasti ◽  
Walter Ageno ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Antiplatelet Drug

Racial differences in persistence to secondary prevention medication regimens after ischemic stroke

2021 ◽  
pp. 1-13
Author(s):  
Orla C. Sheehan ◽  
Mandip S. Dhamoon ◽  
Janet Prvu Bettger ◽  
Jin Huang ◽  
Chelsea Liu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Racial Differences

Pre-Stroke Cholinesterase Inhibitor Treatment Is Beneficially Associated with Functional Outcome in Patients with Acute Ischemic Stroke and Pre-Stroke Dementia: The Fukuoka Stroke Registry

2021 ◽  
pp. 1-7
Author(s):  
Yoshinobu Wakisaka ◽  
Ryu Matsuo ◽  
Kuniyuki Nakamura ◽  
Tetsuro Ago ◽  
Masahiro Kamouchi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Neurological Deterioration ◽  
Stroke Outcome ◽  
Matched Cohort ◽  
Poor Functional Outcome ◽  
Stroke Registry ◽  
Chei Treatment

Introduction: Pre-stroke dementia is significantly associated with poor stroke outcome. Cholinesterase inhibitors (ChEIs) might reduce the risk of stroke in patients with dementia. However, the association between pre-stroke ChEI treatment and stroke outcome remains unresolved. Therefore, we aimed to determine this association in patients with acute ischemic stroke and pre-stroke dementia. Methods: We enrolled 805 patients with pre-stroke dementia among 13,167 with ischemic stroke within 7 days of onset who were registered in the Fukuoka Stroke Registry between June 2007 and May 2019 and were independent in basic activities of daily living (ADLs) before admission. Primary and secondary study outcomes were poor functional outcome (modified Rankin Scale [mRS] score: 3–6) at 3 months after stroke onset and neurological deterioration (≥2-point increase in the NIH Stroke Scale [NIHSS] during hospitalization), respectively. Logistic regression analysis was used to evaluate associations between pre-stroke ChEI treatment and study outcomes. To improve covariate imbalance, we further conducted a propensity score (PS)-matched cohort study. Results: Among the participants, 212 (26.3%) had pre-stroke ChEI treatment. Treatment was negatively associated with poor functional outcome (odds ratio: 0.68 [95% confidence interval: 0.46–0.99]) and neurological deterioration (0.52 [0.31–0.88]) after adjusting for potential confounding factors. In the PS-matched cohort study, the same trends were observed between pre-stroke ChEI treatment and poor functional outcome (0.61 [0.40–0.92]) and between the treatment and neurological deterioration (0.47 [0.25–0.86]). Conclusions: Our findings suggest that pre-stroke ChEI treatment is associated with reduced risks for poor functional outcome and neurological deterioration after acute ischemic stroke in patients with pre-stroke dementia who are independent in basic ADLs before the onset of stroke.

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