Currently submitted to: Journal of Medical Internet Research
Date Submitted: Nov 12, 2026
Open Peer Review Period: Nov 12, 2026 - Jan 7, 2027
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Social media-based coordinated care for high-risk stroke populations (COMPLIANCE-MT): A Multicenter Randomized Controlled Trial
ABSTRACT
Background:
A significant gap persists between clinical guidelines and real-world practice regarding medication adherence after discharge.
Objective:
We assessed whether a social media-based coordinated care program improves patients’ medication adherence in high-risk stroke populations in China.
Methods:
We conducted a multicentre, open-label, blinded-endpoint, randomised controlled trial at 33 centres in China. Adult patients at high risk of stroke were randomly assigned (1:1) before discharge, via a central web-based system, to receive social media-based coordinated care or conventional care. The primary outcome was good medication adherence to all guideline-recommended vascular prevention medications at 12 months post-discharge, assessed by a Composite Medical Adherence Score (CMAS). Analyses were conducted according to the intention-to-treat principle. The treatment effect was estimated using binary logistic regression analysis with adjustment for site and baseline prognostic factors. This trial is registered at ClinicalTrials.gov (NCT05963828).
Results:
Between July 19, 2023, and March 29, 2024, 738 patients were randomly assigned to receive conventional care (n=371) or social media-based care (n=367). At 1 year after discharge, 8 of 367 patients in the intervention group and 6 of 371 patients in the control group died before the assessment of the primary outcome, and another 4 (1.1%) (2 in each group) were lost to follow-up. Good medication adherence was significantly higher in the intervention group compared with the control group (88.2% [315/357] vs 82.1% [298/363]; adjusted OR 1.67, 95% CI 1.08 to 2.56; P =0.021).
Conclusions:
In this multicentre trial conducted in China, a social media-based coordinated care program significantly improved medication adherence at 12 months post-discharge among high-risk stroke populations compared with conventional care. Clinical Trial: ClinicalTrials.gov NCT05963828; https://clinicaltrials.gov/study/NCT05963828
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