Effects of a Disease Management Program for Preventing Recurrent Ischemic Stroke
| Autor: | Naohisa Hosomi, Yasuhiro Ito, Yoshiki Yagita, Kazumi Kimura, Masayasu Matsumoto, for Dmp Stroke Trial Investigators, Yasuko Fukuoka, Takeshi Hyakuta, Toyonori Omori, Michiko Moriyama, Jyunichi Uemura |
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| Rok vydání: | 2019 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty Framingham Risk Score business.industry Hazard ratio Disease medicine.disease law.invention Clinical trial Randomized controlled trial law Internal medicine Clinical endpoint medicine Neurology (clinical) Risk factor Cardiology and Cardiovascular Medicine business Stroke |
| Zdroj: | Stroke. 50:705-712 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background and Purpose— Disease management is a healthcare strategy that includes self-management education and treatment coordination. We conducted a randomized controlled trial to determine whether a disease management program intervention could improve risk factor profiles and, thus, reduce the recurrence of stroke and other cardiovascular diseases. Methods— This study is a prospective randomized, open-label, parallel group study involving outpatients with a history of stroke. Between September 2010 and November 2012, we enrolled patients aged between 40 and 80 years who experienced their last ischemic stroke event or transient ischemic attack within 1 year. After stratifying by the ischemic stroke subtype, 321 subjects (67.5±8.5 years, 95 female) were randomly assigned to either the disease management program intervention group (n=156) or the usual care group (n=165). The primary end point of this study was the difference in the Framingham risk score (general cardiovascular disease 10-year risk) from baseline. The secondary end points of this study included stroke recurrence, onset of cardiovascular disease, all-cause mortality, and all vascular events. Results— Regarding the primary end point, there was no significant difference in the changes in the Framingham risk score at any follow-up time between the groups. The incidence of stroke recurrence tended to be lower in the disease management program intervention group, although no significant difference was found (hazard ratio, 0.49; 95% CI, 0.19–1.29). Conclusions— We were unable to demonstrate a clear benefit of disease management program intervention. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT02121327. |
| Databáze: | OpenAIRE |
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