Primary prevention of cardiovascular disease through population-wide motivational strategies: insights from using smartphones in stroke prevention

Feigin, Valery L.; Norrving, Bo; Mensah, George A.

doi:10.1136/bmjgh-2017-000306

Cited by 54 publications

(47 citation statements)

References 61 publications

(80 reference statements)

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“…If proven effective, it should be included in the WHO “list of essential devices” for individual countries and can be made available in primary/district hospitals for not only primary but also secondary stroke prevention. Global trial of primary prevention using stroke riskometer is being planned and results of the pilot randomized controlled trial will be submitted for publication soon (Feigin et al) [80]. …”

Section: Resultsmentioning

confidence: 99%

Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

et al. 2017

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Background: The burden of stroke in low- and middle-income countries (LMICs) is large and increasing, challenging the already stretched health-care services. Aims and Objectives: To determine the quality of existing stroke-care services in LMICs and to highlight indigenous, inexpensive, evidence-based implementable strategies being used in stroke-care. Methods: A detailed literature search was undertaken using PubMed and Google scholar from January 1966 to October 2015 using a range of search terms. Of 921 publications, 373 papers were shortlisted and 31 articles on existing stroke-services were included. Results: We identified efficient models of ambulance transport and pre-notification. Stroke Units (SU) are available in some countries, but are relatively sparse and mostly provided by the private sector. Very few patients were thrombolysed; this could be increased with telemedicine and governmental subsidies. Adherence to secondary preventive drugs is affected by limited availability and affordability, emphasizing the importance of primary prevention. Training of paramedics, care-givers and nurses in post-stroke care is feasible. Conclusion: In this systematic review, we found several reports on evidence-based implementable stroke services in LMICs. Some strategies are economic, feasible and reproducible but remain untested. Data on their outcomes and sustainability is limited. Further research on implementation of locally and regionally adapted stroke-services and cost-effective secondary prevention programs should be a priority.

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Section: Resultsmentioning

confidence: 99%

Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

et al. 2017

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“…10 In children from the MAL-ED cohort study with Campylobacter infection, approximately 1 cm growth shortfall and an approximate 0.25 kg less weight gain was seen compared to children without Campylobacter; an effect that appeared to be most pronounced at 0-2 months of age. 11 Perhaps even more important than the association between Campylobacter infection and growth faltering is the potential link to environmental enteric dysfunction as recently described by Schnee and Petri. 12 If these associations are confirmed, current burden of disease estimates have likely grossly underestimated the morbidity associated with Campylobacter in children in LMICs.…”

Section: Burden Of Diseasementioning

confidence: 99%

Update on Campylobacter vaccine development

Poly

Noll

Riddle

et al. 2018

Human Vaccines & Immunotherapeutics

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Background: Acute diarrheal disease caused by viral, bacterial and parasitic infections are a major global health problem with substantial mortality and morbidity in children under five years of age in lower and middle income countries. However, a number of these infections also impact large segments of populations in upper income countries, as well as individuals who travel overseas for work, business or pleasure. Campylobacter has been and continues to be a leading cause of disease burden globally across all income countries. Aims: The aim of this review is to describe recent understanding in burden of disease, consider the current landscape of Campylobacter vaccine development, and address the challenges that need to be overcome. Sources: Relevant data from the literature as well as clinical trials described in European and US registries were used to conduct this review. Content: Despite advances in population health, food security, improved sanitation, water quality and the reduction of poverty, Campylobacter infections continue to plague global populations. The emerging recognition of chronic health consequences attributed to this pathogen is changing the potential valuation of preventive interventions. Advancing development of new vaccines is a present opportunity and holds promise.

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“…In this way, the use of new technologies in health could represent an opportunity. The development of population-wide motivational strategies through mobile technology, such as The Stroke Riskometer TM App, to motivate and empower people to reduce their risk of stroke and other cardiovascular diseases can help to improve both primary and secondary prevention across the globe [40, 41]. Furthermore, actions towards health professionals through training and sensitization to prevention or dedicated health professionals could complete the measures to propose a comprehensive stroke prevention program.…”

Section: Discussionmentioning

confidence: 99%

Secondary Prevention Three and Six Years after Stroke Using the French National Insurance Healthcare System Database

et al. 2018

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Background: Secondary prevention is inadequate in the first 2 years after stroke but what happens after that is less documented. The aim of this study was to assess the use and the adherence to preventive drugs 3 and 6 years after experiencing a transient ischemic attack (TIA) or an ischemic stroke (IS). Methods: The population study was from the AVC69 cohort (IS or TIA admitted in an emergency or stroke unit in the Rhône area, France, for an IS or a TIA during a 7-month period). Medication use was defined as ≥1 purchase during the studied year and adherence as Continuous Measure of Medication Acquisition ≥0.8 using the French medical insurance health care funding database. Results: The study population consisted of 210 patients at 3 years and 163 patients at 6 years. Medication use at 3 and 6 years was, respectively, 80.9 and 79.8% for antithrombotics, 69.1 and 66.3% for antihypertensives, 60.5 and 55.2% for statins and 48.6 and 46.6% for optimal treatment defined as the treatment achieved by the use of the 3 drugs. Adherence to each class was good at 3 years and tends to decrease at 6 years. Conclusions: More than one patient out of 2 do not use the optimal preventive treatment.

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Primary prevention of cardiovascular disease through population-wide motivational strategies: insights from using smartphones in stroke prevention

Cited by 54 publications

References 61 publications

Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

Update on Campylobacter vaccine development

Secondary Prevention Three and Six Years after Stroke Using the French National Insurance Healthcare System Database

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