Secondary prevention with a structured semi-interactive stroke prevention package in INDIA (SPRINT INDIA): a multicentre, randomised controlled trial

A Scoping Review of mHealth Interventions for Secondary Prevention of Stroke: Implications for Policy and Practice

“…25,27,34 Intervention durations varied from 4 weeks to 1 year (median, 13 weeks; quartile 1 [Q1], 9; quartile 3 [Q3], 39), with a median age of 58 years (Q1, 56; Q3, 65), a median proportion of 37.5% women (Q1, 35; Q3, 45), and 47.7% (Q1, 35; Q3, 58) high school or tertiary educated. Research funding was provided by government or institutional grants for 12 publications, [23][24][25][26][28][29][30][31][32][33][34][35] and a pharmaceutical company for 1. 27…”

“…Interventions were designed to support the control of risk factors for stroke, including BP, medication adherence, physical activity, diet, and substance use. The most common risk factor targeted was BP reduction/control (8/13), 25,27,28,30,32–35 followed by improving medication adherence (6/13), 27,30,31,33–35 increasing and adhering to physical activity (6/13), 24,26,33–35 improving diet (3/13), 26,33,35 reducing substance use (2/13), 33,34 and reducing cholesterol (1/13). 33 Of the 13 RCTs, 6 were designed to address 1 risk factor, being BP reduction/control (3/13), 25,28 medication adherence (1/13), 31 and physical activity (2/13).…”

“…34 Only 1 phase III RCT had a primary outcome of stroke recurrence as a composite measure that also included high-risk transient ischemic attack, acute coronary syndrome, and death. 33 There was no difference between groups in stroke recurrence and deaths (5.5% of participants in the intervention arm [n=2148] versus 4.9% in the control arm [n=2150]). However, there were reductions in substance use, and improved medication adherence.…”

“…23,28,29,33,35 This included identifying patient needs and iteratively developing and receiving feedback on intervention design and content. Clinicians were also engaged as stakeholders in the development of the intervention of 4 RCTs, 23,32,33,35 with 2 RCTs including caregivers in this process. 32,33 Three qualitative assessments 25,36,37 and 2 mixed-methods studies explored the participants' experiences with the mHealth intervention.…”

“…Information was obtained regarding the current status of the interventions trialed, as well as their future directions for 8 RCTs, sourced from the literature for 2, 29,30 and by correspondence received from authors for 6. 23,25,27,28,31,33 Further evaluations are ongoing for 5 RCTs, including scale-up to phase III RCTs to explore effectiveness, intervention delivery costs and cost-effectiveness, 23,29,30,40,41 process evaluations, 28,40 and assessment of intervention content and delivery mode. 31 There was a lack of information available regarding translation of interventions, with only 1 identified as having been successfully translated into health service.…”