A Scoping Review of mHealth Interventions for Secondary Prevention of Stroke: Implications for Policy and Practice

健康 医学 心理干预 随机对照试验 冲程(发动机) 干预(咨询) 远程医疗 临床试验 物理疗法 老年学 家庭医学 护理部 医疗保健 外科 机械工程 工程类 经济 经济增长 病理
作者
L. Allan,Beilei Lin,Jan Cameron,Muideen T Olaiya,David Silvera‐Tawil,Amelia Adcock,Coralie English,Seana Gall,Dominique A. Cadilhac
出处
期刊:Stroke [Ovid Technologies (Wolters Kluwer)]
卷期号:54 (11): 2935-2945 被引量:3
标识
DOI:10.1161/strokeaha.123.043794
摘要

Secondary prevention is a major priority for those living with stroke and may be improved through the use of mobile Health (mHealth) interventions. While evidence for the effectiveness of mHealth interventions for secondary prevention of stroke is growing, little attention has been given to the translation of these interventions into real-world use. In this review, we aimed to provide an update on the effectiveness of mHealth interventions for secondary prevention of stroke, and investigate their translation into real-world use. Four electronic databases and the gray literature were searched for randomized controlled trials of mHealth interventions for secondary prevention of stroke published between 2010 and 2023. Qualitative and mixed-methods evaluations of the trials were also included. Data were extracted regarding study design, population, mHealth technology involved, the intervention, and outcomes. Principal researchers from these trials were also contacted to obtain further translational information. From 1151 records, 13 randomized controlled trials and 4 evaluations were identified; sample sizes varied widely (median, 56; range, 24–4298). Short message service messages (9/13) and smartphone applications (6/13) were the main technologies used to deliver interventions. Primary outcomes of feasibility of the intervention were achieved in 4 trials, and primary outcomes of changes in risk factors, lifestyle behaviors, and adherence to medication improved in 6 trials. Only 1 trial had a hard end point (ie, stroke recurrence) as a primary outcome, and no significant differences were observed between groups. There was evidence for only 1 intervention being successfully translated into real-world use. Further evidence is required on the clinical effectiveness of mHealth interventions for preventing recurrent stroke, and the associated delivery costs and cost-effectiveness, before adoption into real-world settings.
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