PINGS (Phone-Based Intervention Under Nurse Guidance After Stroke) Interim Results of a Pilot Randomized Controlled Trial
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Stroke
Abstract
Background and Purpose—Stroke exacts an immense toll in sub-Saharan Africa where there are few resources, and stroke
prevention research is limited. The aim of this study is to test the feasibility and preliminary efficacy of an m-Health
technology–enabled, nurse-guided intervention in improving blood pressure (BP) control among Ghanaian stroke patients
within 1 month of symptom onset.
Methods—We conducted a 2-arm cluster pilot randomized controlled trial involving 60 recent stroke survivors encountered
within a single tertiary medical system in Ghana. Subjects in the intervention arm (n=30) received a Blue-toothed UA-
767Plus BT BP device and smartphone for monitoring and reporting BP measurements and medication intake for 3
months compared with standard of care (n=30). Primary outcome measure was systolic BP <140 mm Hg at month 3;
secondary outcomes included medication adherence and autonomous self-regulation. Analysis accounting for clustering
was made using generalized linear mixed model by intention to treat.
Results—Mean±SD age was 55±13 years, 65% male. Systolic BP <140 mm Hg at month 3 was found in 20/30 subjects
(66.7%) in the intervention arm versus 14/30 subjects (46.7%) in the control arm (P=0.12). Medication possession ratio
scores at month 3 were better in the intervention (0.88±0.40) versus control (0.64±0.45) arm (P=0.03). One subject in
control arm died from a recurrent hemorrhagic stroke.
Conclusions—It is feasible to conduct an m-Health–based, nurse-guided BP control intervention among recent stroke
patients in sub-Saharan Africa. We observed a potential signal of efficacy with the intervention, which will need to be
tested in a future large definitive study.
Description
An article published in Stroke. 2018;49:236-239. DOI: 10.1161/STROKEAHA.117.019591.)
Keywords
lood pressure, Hypertension, Medication adherence, Randomized controlled trial, Survivors
Citation
Stroke. 2018;49:236-239. DOI: 10.1161/STROKEAHA.117.019591.)