The purpose of this study is to evaluate the effectiveness of social network in improving drug compliance and risk factors control rate of stroke high-risk population after discharge.
Stroke is the leading cause of death among residents in China, with the characteristics of high morbidity, high mortality, high disability rate, high recurrence rate and so on, which brings huge economic burden to the patients' families and society. Strengthening the comprehensive management of the high-risk population of stroke, improving the medication compliance of patients and the control rate of stroke risk factors play a key role in reducing stroke recurrence. This study is a multicenter, prospective, randomized, single-blind study, which aims to use the tool of WeChat Mini Programs to realize the post-hospital follow-up management of the high-risk population of stroke. The follow-up time is 12 months. The main measurement result was the change of patients' medication compliance after comprehensive management.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
720
The brain and heart health manager uses the exclusive QR code in the WeChat applet to receive and manage patients. Patients can register and use the WeChat applet by scanning the QR code. The functions of WeChat applet include making medication plan for patients, daily medication reminder, targeted health education, health index monitoring, online consultation and so on.
The brain and mental health managers routinely followed up the patients in the standard group for 1, 3, 6 and 12 months by telephone or outpatient follow-up, the main content of which was to inquire about the medication of patients and the management of stroke risk factors. Targeted health education was carried out according to the risk factors of patients.
Changhai Hospital
Shanghai, Shanghai Municipality, China
RECRUITINGPatient's medication adherence to five evidence-based secondary prevention drugs for stroke at 12 months after discharge
Compliance is defined when patients take all evidence-based secondary preventive drugs (antihypertensive, hypoglycemic, lipid-regulating, anticoagulant and antiplatelet drugs) for more than 24 days in 12 months after discharge, that is, the drug taking rate is \> 80% (\> 24/30 days). If the patient adjusts the drug or stops taking the drug by himself, it will be regarded as "non-compliance". If the patient stops taking the drug according to the doctor's advice, it will be regarded as compliance. If the drug is adjusted according to the doctor's advice, it is necessary to continue to ask about the number of days of taking the drug in the past month. If the number of days of taking the drug exceeds 24 days, it will be regarded as compliance.
Time frame: 12 months after discharge
The rate of good compliance with stroke prevention drugs among patients 1 month, 3 months, 6 months and 12 months after discharge
Measured by Morisky Medication Adherence Scale 8 item; Morisky Medication Adherence Scale 8 item
Time frame: 1 month, 3 months，6 months and 12 months after discharge.
The attainment rate of stroke risk factors (blood glucose, blood pressure, blood lipid, BMI, waist circumference, hip circumference, smoking) at 1 month, 3 months, 6 months and 12 months after discharge.
The method of measurement is as follows: Blood lipids: fasting blood sampling measurement Blood glucose: fasting fingertip blood glucose Blood pressure: using a sphygmomanometer to measure BMI: weight (kg) / height (m) \^ 2 Waist circumference, Hip circumference, Smoking: Patient self-report
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
Knowledge of stroke
Measured by The Knowledge questionnaire on prevention and treatment of stroke
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
Personal motivation
Measured by The Stroke Attitude Questionnaire
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
Stroke health behavior improvement
Measured by The Stroke Prevention Health Behavior Scale
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
Social motivation
Measured by Perceived Social Support Scale
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
Health-related quality of life
Measured by The 5-level EQ-5D
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
Incidence of anxiety
Measured by Generalized Anxiety Disorder-7
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
Incidence of depression
Measured by Patient Health Questionnaire-9
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
Self efficacy
Measured by Chronic Disease Self-Efficacy Scale
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
Incidence of major cardiovascular events including stroke, acute coronary syndrome, and vascular death
Stroke: cerebral blood supply disorder caused by acute (focal) neurological syndrome, there is ischemic or hemorrhagic lesion in the corresponding area on brain imaging, or clinical evidence shows negative ischemic lesion on imaging, and the symptoms last longer than 24 hours. Acute coronary syndrome: ①typical clinical symptoms (such as chest pain, heart failure, etc.) accompanied by typical electrocardiogram (ECG) abnormalities; ② typical clinical symptoms with troponin elevated more than 2 times the upper limit of normal;③ or Non-specific symptoms with elevated troponin more than 2 times the upper limit of normal; ④Asymptomatic myocardial infarction diagnosed by follow-up ECG compared with baseline ECG combined with corresponding results of echocardiography or coronary angiography. Vascular death: including death within 30 days after stroke, death within 7 days after acute coronary syndrome, non-cerebral hemorrhage or necrotic death after peripheral artery occlusion or
Time frame: 1 month, 3 months, 6 months and 12 months after discharge
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