Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 6, 2019
Date Accepted: Dec 15, 2019
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Post-stroke mobile healthcare: smartphone-based management system
ABSTRACT
Background:
Advances in mobile health (mHealth) have enabled systematic and continuous management of patients with chronic diseases.
Objective:
We have developed and aimed to evaluate the effect of a smartphone-based mHealth system for health-behavior management and risk factor control in stroke patients.
Methods:
We developed an mHealth management system, which offers multifaceted stroke aftercare including exercise, medication, and education materials and performed a 12-week single-arm intervention in eligible post-stroke patients. The intervention consisted of 1) regular blood pressure (BP), blood glucose, and physical activity measurements, 2) stroke self-education, 3) exercise program, 4) medication program, and 5) feedback with reviewing of records by clinicians. Clinical assessments consisted of stroke awareness score (SAS), Beck Depression Inventory-II (BDI), EuroQol-5 Dimensions (EQ-5D), and BP at visit 1 (baseline), visit 2 (4 weeks), and visit 3 (12 weeks). Temporal differences of parameters over 12 weeks were investigated with repeated-measures analyses of variance.
Results:
Among the 110 patients enrolled for the study from September to December 2016, 99 participants were included in our analyses. SAS (visit 1: 59.6±18.1, visit 3: 74.7±14.0, p < 0.001) and BDI (visit 1: 12.7±10.1, visit 3: 10.7±10.2, p < 0.001) showed gradual improvement; however, no significant differences were found in EQ-5D score. Twenty-six patients who had uncontrolled BP at visit 1 had a -13.92 and -6.19 mmHg decrement on average in systolic and diastolic BP, respectively, without any antihypertensive medication change.
Conclusions:
Awareness of stroke, depression, and BP were enhanced when using the smartphone-based mHealth system. Emerging mHealth techniques hold potential as a new non-pharmacological secondary prevention method because of its ubiquitous access, near real-time responsiveness, and comparatively lower cost. Clinical Trial: No
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