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Randomized Controlled Trial
. 2018 Jan;49(1):236-239.
doi: 10.1161/STROKEAHA.117.019591. Epub 2017 Dec 8.

PINGS (Phone-Based Intervention Under Nurse Guidance After Stroke): Interim Results of a Pilot Randomized Controlled Trial

Fred Sarfo  1 , Frank Treiber  2 , Mulugeta Gebregziabher  2 , Sheila Adamu  2 , Sachin Patel  2 , Michelle Nichols  2 , Dominic Awuah  2 , Asumadu Sakyi  2 , Nyantakyi Adu-Darko  2 , Arti Singh  2 , Raelle Tagge  2 , Jenkins Carolyn  2 , Bruce Ovbiagele  2
Affiliations
Randomized Controlled Trial

PINGS (Phone-Based Intervention Under Nurse Guidance After Stroke): Interim Results of a Pilot Randomized Controlled Trial

Fred Sarfo et al. Stroke. 2018 Jan.

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.

Clinical trial registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02568137.

Keywords: blood pressure; hypertension; medication adherence; randomized controlled trial; survivors.

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Conflict of interest statement

Conflicts of Interest: None for all authors

Figures

Figure 1
Figure 1
Consort Flow Diagram
Figure 2
Figure 2
Systolic Blood Pressure control during follow-up.
See this image and copyright information in PMC

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