Farmalarm

Abstract

Background and Purpose— Risk factor control and treatment compliance in the following months after stroke are poor. We aim to validate a digital platform for smartphones to raise awareness among patients about the need to adopt healthy lifestyle, improve communication with medical staff, and treatment compliance. Methods— Farmalarm is an application (app) for smartphones designed to increase stroke awareness by medication alerts and compliance control, chat communication with medical staff, didactic video files, exercise monitoring. Patients with stroke discharged home were screened for participation and divided into groups: to follow the FARMALARM program for 3 to 4 weeks or standard of care follow-up. We determined achievement of risk factor control goals at 90 days. Results— From August 2015 to December 2016, from the 457 patients discharged home, 159 (34.8%) were included: Farmalarm (n=107); age 57±12, Control (n=52), age 59±10; without significant differences in baseline characteristics between groups. At 90 days, knowledge of vascular risk factors was higher in FARMALARM group (86.0% versus 69.2%, P <0.01). The rate of patients with diabetes mellitus (83.2% versus 63.5%, P <0.01) and hypercholesterolemia (80.3% versus 63.5%, P =0.03) under control and the rate of patients with 4 out of 4 risk factors under control was higher in FARMALARM group (50.4% versus 30.7%, P =0.02). A regression model showed that the use of Farmalarm was independently associated with all risk factors under control at 90 days (odds ratio, 2.3; 95% CI, 1.14–4.6; P =0.02). Conclusions— In patients with stroke discharged home, the use of mobile apps to monitor medication compliance and increase stroke awareness is feasible and seems to improve the control of vascular risk factors.

Digital therapeutics in neurology

“…It allows the patient to monitor his physical activity, record and share vital parameters and capillary blood sugar levels with the physician, monitor therapy adherence, and receive advice about a healthy lifestyle. Through visual and audible alerts, the app showed a valuable tool in secondary stroke prevention, improving medication adherence, and maintaining healthy behaviors [68]. Study findings disclosed a higher rate of total control of critical vascular risk factors in the group that followed the "FARMALARM" program compared to patients who did not [68].…”

“…DTx interventions could be beneficial in increasing medical adherence, maintaining healthy lifestyles, facilitating access to care, improving the effectiveness of care, and lowering costs of care [67][68][69][70][71][72][73][74][75][76][77].…”

“…Adherence to medical therapy in stroke patients remains an unmet need and continues to burden the healthcare system [66][67][68]. "FARMALARM" is a smartphone application available in the Spanish language used in secondary stroke prevention.…”

“…Through visual and audible alerts, the app showed a valuable tool in secondary stroke prevention, improving medication adherence, and maintaining healthy behaviors [68]. Study findings disclosed a higher rate of total control of critical vascular risk factors in the group that followed the "FARMALARM" program compared to patients who did not [68]. In a pilot study, [67] a digital self-management program, using a personal coach and digital platform, was developed to improve the monitoring of vascular risk factors after stroke.…”

Stroke és a cardiorespiratoricus fittség

“…A 'Mental contrasting with implementation intentions' (MCII) önszabályozó stratégia megtanítása elősegítette a fizikai aktivitásra vonatkozó információk érvényesítését, 50 héttel a stroke után is [40]. A smartphoneok (okostelefonok) segíthetnek az elbocsátott betegek együttműködésének fokozásában, a gyógyszerszedés, a testmozgás, a vérnyomáskontroll, az orvossal való kapcsolat terén [41].…”