TY - JOUR

T1 - Lifestyle counselling as secondary prevention in patients with minor stroke or transient ischemic attack

T2 - a randomized controlled pilot study

AU - Liljehult, Jacob

AU - Molsted, Stig

AU - Møller, Tom

AU - Overgaard, Dorthe

AU - Christensen, Thomas

N1 - Publisher Copyright: © The Author(s) 2024.

PY - 2024

Y1 - 2024

N2 - Background: Patients with minor stroke or transient ischemic attacks have an increased risk of future strokes. These patients are often discharged home with limited specialized follow-up, although close to half of them experience cognitive deficits. Simple encouragements to avoid smoking, be physically active, and to take preventive medication are often insufficient to ensure adherence and more comprehensive interventions are needed to support the patients in adapting healthy behaviour. The aim of this study was to test the feasibility and potential effect of an early initiated, patient-centred intervention to patients with minor stroke or transient ischemic attacks targeting smoking, physical activity, and medication adherence, in a randomized, controlled pilot trial. Methods: Hospitalized patients were randomized to usual care or an intervention consisting of health behavioural counselling based on the 5A’s model, telephone follow-up (4 and 8 weeks), and monitoring of physical activity. Follow-up time was 12 weeks. Feasibility was on the following domains: eligibility, acceptance, demand and practicality, adherence, attrition, and implementation and integration. Results: Forty patients of 84 potentially eligible were randomized to the two treatment arms (20 intervention/20 usual care). Thirty-two completed the 12-week follow-up, while 8 were either excluded or lost to follow-up. With few changes, the intervention was feasible and possible to deliver according to the protocol. Conclusion: It was possible to identify relevant patients who could potentially benefit from a behavioural intervention, recruit and randomize them early after admission and retain most participants in the study until follow-up and derive statistical estimates to guide the design of large-scale randomized controlled trials. Trial registration: ClinicalTrials.gov Identifier: NCT03648957. Registered 28 August 2018.

AB - Background: Patients with minor stroke or transient ischemic attacks have an increased risk of future strokes. These patients are often discharged home with limited specialized follow-up, although close to half of them experience cognitive deficits. Simple encouragements to avoid smoking, be physically active, and to take preventive medication are often insufficient to ensure adherence and more comprehensive interventions are needed to support the patients in adapting healthy behaviour. The aim of this study was to test the feasibility and potential effect of an early initiated, patient-centred intervention to patients with minor stroke or transient ischemic attacks targeting smoking, physical activity, and medication adherence, in a randomized, controlled pilot trial. Methods: Hospitalized patients were randomized to usual care or an intervention consisting of health behavioural counselling based on the 5A’s model, telephone follow-up (4 and 8 weeks), and monitoring of physical activity. Follow-up time was 12 weeks. Feasibility was on the following domains: eligibility, acceptance, demand and practicality, adherence, attrition, and implementation and integration. Results: Forty patients of 84 potentially eligible were randomized to the two treatment arms (20 intervention/20 usual care). Thirty-two completed the 12-week follow-up, while 8 were either excluded or lost to follow-up. With few changes, the intervention was feasible and possible to deliver according to the protocol. Conclusion: It was possible to identify relevant patients who could potentially benefit from a behavioural intervention, recruit and randomize them early after admission and retain most participants in the study until follow-up and derive statistical estimates to guide the design of large-scale randomized controlled trials. Trial registration: ClinicalTrials.gov Identifier: NCT03648957. Registered 28 August 2018.

KW - Adherence

KW - Early rehabilitation

KW - Exercise

KW - Health counselling

KW - Physical activity

KW - Smoking

KW - Stroke

KW - Transient ischemic attack

U2 - 10.1186/s40814-024-01478-4

DO - 10.1186/s40814-024-01478-4

M3 - Journal article

C2 - 38519983

AN - SCOPUS:85188440514

VL - 10

JO - Pilot and Feasibility Studies

JF - Pilot and Feasibility Studies

SN - 2055-5784

IS - 1

M1 - 50

ER -