The purpose of this study is to determine whether an outpatient program can reduce the risk of recurrent stroke.
Stroke is a major cause of death and disability. A history of stroke is the strongest predictor of a future stroke. Control of risk factors lowers the risk of future stroke, yet most persons with stroke do not have their risk factors controlled.
In this randomized-controlled trial, we will test whether an outpatient stroke prevention program consisting of group clinics, patient self-management, and telephone care coordination can lower the risk of recurrent stroke by improving patient knowledge, medication adherence, and lifestyle habits. If successful, this program may be adapted to other settings.
- Stroke prevention care program Other
Other Names: group clinics; chronic care model; secondary stroke prevention program; nurse practitioner; medication algorithms Intervention Desc: Stroke prevention care program consists of group clinics, telephone coordination of care, and tracking of care through registries in the first 7 months after stroke or TIA presentation. A nurse practitioner will follow algorithms to adjust medications and to motivate patients to improve lifestyle habits. ARM 1: Kind: Experimental Label: Stroke Prevention Program + Usual Care Description: Stroke Prevention Care Program + Usual Care. The Stroke prevention care program is in addition, not a substitute for usual care. Persons randomized to this arm are eligible to all care, including care by stroke specialists, while enrolled in the intervention.
- Allocation: Randomized
- Masking: Double Blind (Investigator, Outcomes Assessor)
- Purpose: Prevention
- Endpoint: Efficacy Study
- Intervention: Single Group Assignment
|Type||Measure||Time Frame||Safety Issue|
|Primary||Blood pressure control||baseline, 3 months, 7 months||No|
|Secondary||control of other stroke risk factors including lipids, smoking, and exercise||baseline, 3 months, 7 months||No|
|Secondary||patient perceptions of care quality||baseline, 3 months, 7 months||No|
|Secondary||medication adherence||baseline, 3 months, 7 months||No|
|Secondary||Stroke knowledge||baseline, 3 months, 7 months||No|