Relationship between Risk Factor Control and Compliance with a Lifestyle Modification Program in the Stenting Aggressive Medical Management for Prevention of Recurrent Stroke in Intracranial Stenosis Trial
| Autor: | Jean Montgomery, Michael J. Lynn, Bethany F Lane, Marc I. Chimowitz, L. Scott Janis, David Fiorella, Tanya N. Turan, Sami Al Kasab, Jamie Harrell, Sammpris Investigators, Azhar Nizam, Colin P. Derdeyn |
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| Rok vydání: | 2018 |
| Předmět: |
Counseling
Male medicine.medical_specialty Time Factors Constriction Pathologic 03 medical and health sciences 0302 clinical medicine Lifestyle modification Recurrence Risk Factors Recurrent stroke Secondary Prevention medicine Humans 030212 general & internal medicine Risk factor Stroke Aged Chi-Square Distribution business.industry Vascular disease Endovascular Procedures Rehabilitation Middle Aged Intracranial Arteriosclerosis medicine.disease United States Telephone Compliance (physiology) Treatment Outcome Blood pressure Physical therapy Patient Compliance Female Stents Surgery Neurology (clinical) Cardiology and Cardiovascular Medicine business Risk Reduction Behavior Body mass index 030217 neurology & neurosurgery |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 27:801-805 |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2017.10.017 |
| Popis: | Background Lifestyle modification programs have improved the achievement of risk factor targets in a variety of clinical settings, including patients who have previously suffered a stroke or transient ischemic attack and those with multiple risk factors. Stenting Aggressive Medical Management for Prevention of Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) was the first vascular disease prevention trial to provide a commercially available lifestyle modification program to enhance risk factor control. We sought to determine the relationship between compliance with this program and risk factor control in SAMMPRIS. Methods SAMMPRIS aggressive medical management included a telephonic lifestyle modification program provided free of charge to all subjects (n = 451) during their participation in the study. Subjects with fewer than 3 expected lifestyle-coaching calls were excluded from these analyses. Compliant subjects (n = 201) had greater than or equal to 78.5% of calls (median % of completed/expected calls). Noncompliant subjects (n = 200) had less than 78.5% of calls or refused to participate. Mean risk factor values or % in-target for each risk factor was compared between compliant versus noncompliant subjects, using t tests and chi-square tests. Risk factor changes from baseline to follow-up were compared between the groups to account for baseline differences. Results Compliant subjects had better risk factor control throughout follow-up for low-density lipoprotein, systolic blood pressure (SBP), hemoglobin A1c (HgA1c), non–high-density lipoprotein, nonsmoking, and exercise than noncompliant subjects, but there was no difference for body mass index. After adjusting for baseline differences between the groups, compliant subjects had a greater change from baseline than noncompliant subjects for SBP did at 24 months and HgA1c at 6 months. Conclusion SAMMPRIS subjects who were compliant with the lifestyle modification program had better risk factor control during the study for almost all risk factors. |
| Databáze: | OpenAIRE |
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