Cargando…

Lifestyle counselling as secondary prevention in patients with minor stroke and transient ischemic attack: study protocol for a randomized controlled pilot study

BACKGROUND: Most patients with minor stroke or transient ischemic attack (TIA) are discharged with little or no specialised follow-up. Nonetheless, these patients have a high prevalence of cognitive impairments and a considerable risk of recurrent stroke. Smoking cessation, physical activity, and ad...

Descripción completa

Detalles Bibliográficos
Autores principales: Liljehult, Jacob, Molsted, Stig, Møller, Tom, Overgaard, Dorthe, Adamsen, Lis, Jarden, Mary, Christensen, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093950/
https://www.ncbi.nlm.nih.gov/pubmed/32226634
http://dx.doi.org/10.1186/s40814-020-00583-4
_version_ 1783510375522631680
author Liljehult, Jacob
Molsted, Stig
Møller, Tom
Overgaard, Dorthe
Adamsen, Lis
Jarden, Mary
Christensen, Thomas
author_facet Liljehult, Jacob
Molsted, Stig
Møller, Tom
Overgaard, Dorthe
Adamsen, Lis
Jarden, Mary
Christensen, Thomas
author_sort Liljehult, Jacob
collection PubMed
description BACKGROUND: Most patients with minor stroke or transient ischemic attack (TIA) are discharged with little or no specialised follow-up. Nonetheless, these patients have a high prevalence of cognitive impairments and a considerable risk of recurrent stroke. Smoking cessation, physical activity, and adherence to antihypertensive and antithrombotic medication are highly recommended in patients with minor stroke and TIA. Evidence suggests that simple encouragement to change lifestyle is ineffective. Behavioural interventions might therefore be needed to support patients in managing their own health post-discharge. OBJECTIVES: We aim to test the (1) feasibility of randomisation acceptance and an early initiated, client-centred lifestyle and behavioural intervention in a clinical setting, and (2) potential effect of the intervention on arterial blood pressure in patients with minor stroke or TIA and (3) explore the participants experience of barriers and facilitators for health behaviour after a stroke, including perceived needs and social support. METHODS: We will conduct a randomized controlled pilot trial: Eligible patients with acute minor stroke or TIA (n = 40) will be randomly allocated to either early initiated counselling with four weekly post-discharge follow-up sessions for 12 weeks or usual care. The primary outcome will be program feasibility and to discuss the relevance of arterial blood pressure as primary outcome after 12 weeks intervention. Selected participants will be invited to participate in semi-structured interviews, based on purposeful sampling, to evaluate the intervention and explore their experience of life after a stroke. The interviews will be analysed using a five-step thematic analysis approach. DISCUSSION: The study will provide evidence of the feasibility and potential effect of early initiated counselling on cardiovascular risk factors in patients with minor stroke and TIA. Qualitative interviews will contribute with a more nuanced understanding of the barriers and facilitators of health enhancing behaviour. Optimizing health behaviour counselling and providing formal support to the patients’ post-discharge may ease the transition and help more patients adhere to lifestyle and medication recommendations. TRIAL REGISTRATION: ClinicalTrial.gov, NCT03648957
format Online
Article
Text
id pubmed-7093950
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-70939502020-03-27 Lifestyle counselling as secondary prevention in patients with minor stroke and transient ischemic attack: study protocol for a randomized controlled pilot study Liljehult, Jacob Molsted, Stig Møller, Tom Overgaard, Dorthe Adamsen, Lis Jarden, Mary Christensen, Thomas Pilot Feasibility Stud Study Protocol BACKGROUND: Most patients with minor stroke or transient ischemic attack (TIA) are discharged with little or no specialised follow-up. Nonetheless, these patients have a high prevalence of cognitive impairments and a considerable risk of recurrent stroke. Smoking cessation, physical activity, and adherence to antihypertensive and antithrombotic medication are highly recommended in patients with minor stroke and TIA. Evidence suggests that simple encouragement to change lifestyle is ineffective. Behavioural interventions might therefore be needed to support patients in managing their own health post-discharge. OBJECTIVES: We aim to test the (1) feasibility of randomisation acceptance and an early initiated, client-centred lifestyle and behavioural intervention in a clinical setting, and (2) potential effect of the intervention on arterial blood pressure in patients with minor stroke or TIA and (3) explore the participants experience of barriers and facilitators for health behaviour after a stroke, including perceived needs and social support. METHODS: We will conduct a randomized controlled pilot trial: Eligible patients with acute minor stroke or TIA (n = 40) will be randomly allocated to either early initiated counselling with four weekly post-discharge follow-up sessions for 12 weeks or usual care. The primary outcome will be program feasibility and to discuss the relevance of arterial blood pressure as primary outcome after 12 weeks intervention. Selected participants will be invited to participate in semi-structured interviews, based on purposeful sampling, to evaluate the intervention and explore their experience of life after a stroke. The interviews will be analysed using a five-step thematic analysis approach. DISCUSSION: The study will provide evidence of the feasibility and potential effect of early initiated counselling on cardiovascular risk factors in patients with minor stroke and TIA. Qualitative interviews will contribute with a more nuanced understanding of the barriers and facilitators of health enhancing behaviour. Optimizing health behaviour counselling and providing formal support to the patients’ post-discharge may ease the transition and help more patients adhere to lifestyle and medication recommendations. TRIAL REGISTRATION: ClinicalTrial.gov, NCT03648957 BioMed Central 2020-03-25 /pmc/articles/PMC7093950/ /pubmed/32226634 http://dx.doi.org/10.1186/s40814-020-00583-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Study Protocol
Liljehult, Jacob
Molsted, Stig
Møller, Tom
Overgaard, Dorthe
Adamsen, Lis
Jarden, Mary
Christensen, Thomas
Lifestyle counselling as secondary prevention in patients with minor stroke and transient ischemic attack: study protocol for a randomized controlled pilot study
title Lifestyle counselling as secondary prevention in patients with minor stroke and transient ischemic attack: study protocol for a randomized controlled pilot study
title_full Lifestyle counselling as secondary prevention in patients with minor stroke and transient ischemic attack: study protocol for a randomized controlled pilot study
title_fullStr Lifestyle counselling as secondary prevention in patients with minor stroke and transient ischemic attack: study protocol for a randomized controlled pilot study
title_full_unstemmed Lifestyle counselling as secondary prevention in patients with minor stroke and transient ischemic attack: study protocol for a randomized controlled pilot study
title_short Lifestyle counselling as secondary prevention in patients with minor stroke and transient ischemic attack: study protocol for a randomized controlled pilot study
title_sort lifestyle counselling as secondary prevention in patients with minor stroke and transient ischemic attack: study protocol for a randomized controlled pilot study
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093950/
https://www.ncbi.nlm.nih.gov/pubmed/32226634
http://dx.doi.org/10.1186/s40814-020-00583-4
work_keys_str_mv AT liljehultjacob lifestylecounsellingassecondarypreventioninpatientswithminorstrokeandtransientischemicattackstudyprotocolforarandomizedcontrolledpilotstudy
AT molstedstig lifestylecounsellingassecondarypreventioninpatientswithminorstrokeandtransientischemicattackstudyprotocolforarandomizedcontrolledpilotstudy
AT møllertom lifestylecounsellingassecondarypreventioninpatientswithminorstrokeandtransientischemicattackstudyprotocolforarandomizedcontrolledpilotstudy
AT overgaarddorthe lifestylecounsellingassecondarypreventioninpatientswithminorstrokeandtransientischemicattackstudyprotocolforarandomizedcontrolledpilotstudy
AT adamsenlis lifestylecounsellingassecondarypreventioninpatientswithminorstrokeandtransientischemicattackstudyprotocolforarandomizedcontrolledpilotstudy
AT jardenmary lifestylecounsellingassecondarypreventioninpatientswithminorstrokeandtransientischemicattackstudyprotocolforarandomizedcontrolledpilotstudy
AT christensenthomas lifestylecounsellingassecondarypreventioninpatientswithminorstrokeandtransientischemicattackstudyprotocolforarandomizedcontrolledpilotstudy