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"Secondary Prevention By Structured Semi-Interactive Stroke Prevention Package in INDIA (SPRINT INDIA) Study
India (MSAI) - Christian Medical College, Ludhiana
Dr. Jeyaraj D Pandian
Mahesh P Kate
Type of Research Project
- Clinical Project with Laboratory work
What is the background of the project?
Stroke is the one of the leading causes of disability and death. In India 15% to 20% of patients develop stroke recurrence after a first stroke. The recurrent stroke rates have markedley decreased in developed countries due to early identification of risk factors and management of the same. The most common causes of recurrent stroke is poor compliance with drugs, and lack of control of blood pressure, blood sugar etc. Health education through short messaging services have shown benefit in the effective control of blood presure and blood sugar in stroke patients. However it is largely unknown whether simlar interventions can reduce the recurrent stroke rates.
What is the aim of the project?
To assess the role of a structured semi-interactive stroke prevention package to reduce the risk of recurrent strokes, myocardial infarction and death in patients with sub-acute stroke after one month.
What techniques and methods are used?
Patients will be randomised centrally through centralised process to either the intervention arom or control arm. This study is being carried out in 27 stroke centers in India under the Indian Stroke Clinical Trial Ntework (INSTRuCT). https://instructnetwork.in/ The study will deliver three interventions. I. Stroke Prevention Workbook with activities II. Messaging for Adherence of medication and Health Education via Short messaging Service/ Whatsapp/other messaging service used by patient or immediate caregiver (5 days a week for 1 year) III. Health Education Videos to be viewed on cellular device or any other device available to the patients or immediate care giver. (1 day a week for 1 year) Primary Outcome: stroke, transient ischemic attack or myocardial infarction Secondary outcome: compliance of drugs, control of BP, Blood sugar Patients will be followed up for 1 year and outcome events will be adjudicated by a separate independent committee. Statistical analysis will be done using SPSS ver 21.0. We will first compare baseline characteristics in two groups to assess the effect of randomizations. The risk factors are nominal variable and difference will be calculated using Chi Square test. The blood pressure and blood investigations are continuous variable and differences will be assessed using Students ‘t’ Test. The primary outcome of the study is nominal variable a composite predefined endpoint and will be analyzed by Chi Square test. A p <0.05 will be considered as significant. Time-to-event analysis will be done by Kaplan Meier survival curve at one year. The secondary outcome measure including reduction in blood pressure, drop in LDL cholesterol, triglycerides will be analyzed using ANCOVA. Smoking and alcohol cessation will be assessed using Chi Square test.
What is the role of the student?
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks of the student will be performed on his/her own
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
1) Practical skills regarding examining stroke patients 2) Screening patient eligibility and recruiting patients along with research staff 3) Can be involved in writing a review article on prevention of stroke with the tutor
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Yes, thorugh lectures and seminars
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a scientific report
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Clinincal and analytical skills
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- A randomized controlled behavioral intervention trial to improve medication adherence in adult stroke patients with prescription tailored Short Messaging Service (SMS)-SMS4Stroke study. Kamal AK; Shaikh Q; Pasha O; Azam I; Islam M; Memon AA; Rehman H; Akram MA; Affan M; Nazir S; Aziz S; Jan M; Andani A; Muqeet A; Ahmed B; Khoja S. BMC Neurol. 2015 Oct 21;15:212.
- Improving medication adherence in stroke patients through Short Text Messages (SMS4Stroke)-study protocol for a randomized; controlled trial. Kamal AK; Shaikh QN; Pasha O; Azam I; Islam M; Memon AA; Rehman H; Affan M; Nazir S; Aziz S; Jan M; Andani A; Muqeet A; Ahmed B; Khoja S. BMC Neurol. 2015 Aug 28;15:157
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