Mobile health intervention can help to prevent secondary stroke: ICMR study
Feb 18, 2023
New Delhi [India], February 18 : Mobile health intervention can lead to improved lifestyle-related behaviours that can prevent secondary stroke, according to a research paper published by the Indian Council of Medical Research (ICMR).
The study was done across 31 stroke centres in India. The trial's intervention was a package composed of SMS text messages, health education videos and a stroke prevention workbook for patients.
The messages focused on control of blood sugar, blood pressure, and cholesterol, improving physical activity, eating a healthy diet and not missing taking medicines to prevent stroke.
The results of the trial were published in the Lancet Global Health journal on February 14, 2023.
The awareness material was systematically developed in 12 different regional languages. The patients in the control group received standard care whereas those in the intervention arm received awareness material at weekly intervals to promote healthy living and adherence to medicines. A total of 4,298 patients were randomly allocated to the intervention arm (2148) and control arm (2150). 1502 patients in the intervention arm and 1536 patients in the control arm completed 1-year follow-up.
The trial went a step further than contemporary trials in assessing the effect on endpoints such as the recurrence of cardiovascular events and deaths. However, the follow-up period was short to show any differences between the control and intervention groups.
According to Dr Jeyaraj D Pandian, Professor of Neurology and Principal of Christian Medical College, Ludhiana who is the Principal Investigator of the clinical coordinating centre for the trial said, "The proportion of patients who stopped smoking (83%) and alcohol (85%) improved in the intervention group as compared to the control group (78% and 75% respectively). Adherence to medications was also better in the intervention arm (94%) as compared to the control arm (89%)."
Pandian further said that the events like stroke, heart attack and death 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 study centers were stroke-ready centers, which were already providing good quality of care to stroke patients," the professor added.
Dr Meenakshi Sharma Scientist-G, Noncommunicable Diseases Division, ICMR said that said the trial provides hope in improving lifestyle and medical complications by leveraging technology in a resource-constrained setup
She further said, "SPRINT study is the first trial in India (and perhaps globally) to try to assess the role of a mHealth intervention in secondary prevention of stroke at such a large scale. It provides hope in improving lifestyle and medical complications by leveraging technology in a resource-constrained setup. In phase 2 which started in September 2022, 4 more stroke trials, which are very relevant to the country, have been initiated by ICMR. We would get answers to important treatments for stroke in the coming years."
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 brain arteries and brain haemorrhage when there is rupture and leakage of one of the arteries which supply blood to the brain.
High blood pressure is the number one cause of ischemic and hemorrhagic strokes. High blood sugar, high cholesterol, smoking, obesity, alcohol intake, lack of exercise and unhealthy diet are the other reasons why stroke occurs.