Randomised controlled trial to evaluate the efficacy and usability of a computerised phone-based lifestyle coaching system for primary and secondary prevention of stroke

Abstract

BackgroundOne of the most effective current approaches to preventing stroke events is the reduction of lifestyle risk factors, such as unhealthy diet, physical inactivity and smoking. In this study, we assessed the efficacy and usability of the phone-based Computer-aided Prevention System (CAPSYS) in supporting the reduction of lifestyle-related risk factors.MethodsA single-centre two-arm clinical trial was performed between January 2013 and February 2014, based on individual follow-up periods of six months with 94 patients at high risk of stroke, randomly assigned to an intervention group (IC: 48; advised to use the CAPSYS system) or a standard care group (SC: 46). Study parameters, such as blood pressure, blood values (HDL, LDL, HbA1c, glycaemia and triglycerides), weight, height, physical activity as well as nutrition and smoking habits were captured through questionnaires and medical records at baseline and post-intervention and analysed to detect significant changes. The usability of the intervention was assessed based on the standardised System Usability Scale (SUS) complemented by a more system-specific user satisfaction and feedback questionnaire.ResultsThe statistical evaluation of primary measures revealed significant decreases of systolic blood pressure (mean of the differences = –9 mmHg; p = 0.03; 95 % CI = [–17.29, –0.71]), LDL (pseudo-median of the differences = –7.9 mg/dl; p = 0.04; 95 % CI = [–18.5, –0.5]) and triglyceride values (pseudo-median of the differences = –12.5 mg/dl; p = 0.04; 95 % CI = [–26, –0.5]) in the intervention group, while no such changes could be observed in the control group. Furthermore, we detected a statistically significant increase in self-reported fruit and vegetable consumption (pseudo-median of the differences = 5.4 servings/week; p = 0.04; 95 % CI = [0.5, 10.5]) and a decrease in sweets consumption (pseudo-median of the differences = –2 servings/week; p = 0.04; 95 % CI = [–4, –0.00001]) in the intervention group. The usability assessment showed that the CAPSYS system was, in general, highly accepted by the users (average SUS score: 80.1).ConclusionsThe study provided encouraging results indicating that a computerised phone-based lifestyle coaching system, such as CAPSYS, can support the usual treatment in reducing cerebro-cardiovascular risk factors and that such an approach is well applicable in practice.Trial registrationClinicalTrials.gov Identifier: NCT02444715

Telerehabilitation System in Nursing Post Stroke - A Systematic Review

“…The existence of the current inpatient rehabilitation and outpatient care should be sustainable. Many forms telerehabilitation as a form of post-stroke intervention may show promising results (van de Ven, Schmand, Groet, Veltman, & Murre, 2015). By using the telerehabilitation system, it is possible to provide rehabilitation services at the patient's home or in the form of community-based technology, allowing the healthcare professionals to monitor a patient's health status and to identify the conditions that require improvement before ill effects occur (J.…”

“…By using the telerehabilitation system, it is possible to provide rehabilitation services at the patient's home or in the form of community-based technology, allowing the healthcare professionals to monitor a patient's health status and to identify the conditions that require improvement before ill effects occur (J. Kim et al, 2016;van de Ven et al, 2015).…”

“…The system uses text to speech software (TTS) in CAPSYS to read the blood pressure and to provide direct feedback. The system lifestyle in the form of computerized telephone-based coaching can support the usual treatment in reducing the risk factors of cerebro-cardiovascular damage (Sarfo et al, 2018;Spassova, Vittore, Droste, & Rösch, 2016).…”

Modifiable Risk Factors for Stroke and Strategies for Stroke Prevention

“…105 Additionally, Spassova et al found that participants (n ¼ 94) who received a phone-based, algorithmic-automated lifestyle information provided twice a week for 6 months had favorable outcomes for BP, cholesterol, triglycerides, and diet. 119 Maasland et al (n ¼ 57) compared stroke education provided by a physician in combination with computerized lifestyle education with usual care with a physician. 127 Both studies corroborated that education provided at predetermined intervals (i.e., at 10 weeks, 5 and 8 months) and over the computer were not more effective than usual care with a physician.…”

Nursing Diagnoses According to NANDA-I, NIC-Nursing Interventions and NOC Outcomes of Individuals Who Suffered Ischemic Stroke

“…7 Bu konuda yapılan araştırmalarda, inme geçiren hastaların yaşam kalitesinin yükseltilmesinde özellikle hemşirelik bakım, uygulama ve girişimlerinin son derece önemli rol oynadığı bildirilmektedir. 10,11 Hemşirelerin, hastaların bakım gereksinimlerini optimum düzeyde karşılayabilmesi, hemşirelik bakımının standartlar doğrultusunda planlanması, uygulanması ve değerlendirilmesine bağlıdır. Bakımda ortak bir dil oluşturulması, bireyin holistik ve hümanistik bir yaklaşım doğrultusunda ele alınması, uygulamaların kanıta dayandırılması, bakımın sistematik bir yaklaşımla sunulması ve verilen bakımın kalitesinin güvence altına alınması önemlidir.…”