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Prevention of Ischemic Stroke Recurrence Using Digital Technology Application (DESIRE)

13 septembre 2026 mis à jour par: Affiliated Hospital of Nantong University

Prevention of Ischemic Stroke Recurrence Using Digital Technology Application: a Randomized Controlled Trial

The goal of this study is to find out whether a comprehensive management program that uses a smart bracelet and a mobile app can help people who have had an ischemic stroke (a type of stroke caused by a blocked blood vessel in the brain) to prevent another stroke. The investigators also want to see whether this program helps with controlling blood pressure, blood sugar, and blood lipids, as well as with taking medications correctly, improving daily habits, and supporting emotional well-being.

The investigators are focusing on two main questions:

  • After using this digital management tool, will the chance of having another stroke within one year after leaving the hospital be lower?
  • Compared with people who only receive regular care, will those who use the tool show better control of blood pressure, blood sugar, and blood lipids, better medication adherence, and healthier lifestyles?

People who join the study will be randomly assigned to one of two groups. One group will receive usual stroke prevention care (the control group). The other group will get the same usual care plus an additional 12-month program that includes a smart bracelet and a mobile app (the intervention group).

If participants are in the intervention group, participants will:

  • Wear a smart bracelet continuously and use a mobile app for 12 months.
  • Receive health tips, medication reminders, blood-pressure measurement reminders, activity goals, and vibration alerts when participants have been sitting too long through the app.

If participants are in either group, participants will:

  • Come to the clinic for check-ups and assessments at the start of the study, and again at 3 months, 6 months, and 12 months.
  • Have neurological function of participants, daily activity abilities, quality of life, medication adherence, and mood (depression and anxiety) assessed at those visits.
  • Have blood tests to check metabolic risk factors of participants(e.g., blood lipids and glucose) at the same visits.
  • Report to the research team if participants experience another stroke, any cardiovascular event, or death at each follow-up visit.

The investigators will compare the two groups to see if the digital program makes a real difference in reducing stroke recurrence and improving overall health after a stroke.

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Estimé)

1696

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Sauvegarde des contacts de l'étude

Lieux d'étude

  • Chine
    • Jiangsu
      • Nantong, Jiangsu, Chine, 226000
        • Affiliated Hospital of Nantong University
        • Contact:
          • Tian Xu, MD, PhD
          • Numéro de téléphone: +8618251313276
          • E-mail: xutian84@163.com
        • Contact:

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

La description

Inclusion Criteria:

  • Age 18 years or older.
  • Diagnosed with ischemic stroke within the past 3 months, confirmed by cranial CT or MRI.
  • Have both hypertension and diabetes as concurrent metabolic risk factors for stroke recurrence.
  • Possess basic communication skills and ability to understand the study content and provide written informed consent.
  • The participant or their primary caregiver is able to use a smart wearable device, has access to a smartphone, and is willing to complete follow-up visits as required by the study protocol.

Exclusion Criteria:

  • Life expectancy less than 12 months, or presence of severe cardiac, hepatic, renal, or other systemic diseases that would make participation in follow-up inappropriate.
  • Severe cognitive impairment, aphasia, psychiatric disorders, or disturbance of consciousness that prevents cooperation with the study, without a stable caregiver to assist.
  • Severe physical disability or other reasons that preclude wearing or using the wearable device.
  • Currently participating in another interventional study that may affect stroke recurrence outcomes.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: La prévention
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Digital Prevention Management
This arm receives the wearable device + digital platform intervention, which is the focus of the study and is being tested for efficacy.
Dispositif: Digital Prevention Management
Participants in this arm receive usual stroke secondary prevention management plus a 12-month comprehensive digital intervention consisting of: Wearable Device (Smart Bracelet) + Digital Platform (Mobile Application)
Comparateur actif: Usual Stroke Secondary Prevention
This arm receives usual stroke secondary prevention management, which is the current standard of care and is considered effective in treating/ preventing the condition under study.
Autre: Usual Stroke Secondary Prevention Management
Participants in this arm receive standard care according to current clinical guidelines for stroke secondary prevention.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Number of Participants With First Recurrent Stroke
Délai: From randomization through 12 months
Recurrent stroke is defined as a new ischemic or hemorrhagic stroke occurring after randomization and confirmed by an independent blinded endpoint adjudication committee based on clinical findings and brain CT or MRI. If a participant experiences more than one recurrent stroke, only the first qualifying event will be counted.
From randomization through 12 months

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Percentage of Participants Achieving the Prespecified Blood Pressure Target
Délai: At 3, 6, and 12 months after randomization
Blood pressure control is defined as a mean seated systolic blood pressure below 130 mm Hg and a mean seated diastolic blood pressure below 80 mm Hg. Blood pressure will be measured using a validated device after at least 5 minutes of rest. The mean of three measurements obtained at each visit will be used. The outcome will be reported as the percentage of participants meeting both targets.
At 3, 6, and 12 months after randomization
Percentage of Participants Achieving the Prespecified Glycemic Target
Délai: At 3, 6, and 12 months after randomization
Glycemic control is defined as a glycated hemoglobin A1c level below 7.0 percent. The outcome will be calculated as the number of participants meeting the prespecified target divided by the number of participants with an available glycated hemoglobin A1c measurement at the corresponding visit.
At 3, 6, and 12 months after randomization
Percentage of Participants Achieving the Prespecified Low-Density Lipoprotein Cholesterol Target
Délai: At 3, 6, and 12 months after randomization
Lipid control is defined as a low-density lipoprotein cholesterol level below 1.8 mmol/L or achievement of the individualized target specified in the protocol. If individualized targets are used, the target-assignment algorithm will be prespecified before enrollment. The outcome will be reported as the percentage of participants achieving their assigned target.
At 3, 6, and 12 months after randomization
Number of Participants Who Die From Any Cause
Délai: From randomization through 12 months
All-cause mortality is defined as death from any cause occurring after randomization. Deaths will be verified using hospital records, death certificates, or other available source documents and reviewed by an independent endpoint adjudication committee blinded to treatment allocation.
From randomization through 12 months
Number of Participants Who Die From a Cardiovascular Cause
Délai: From randomization through 12 months
Cardiovascular death is defined as death attributable to stroke, myocardial infarction, heart failure, sudden cardiac death, or another vascular cause, according to prespecified endpoint definitions. All suspected cardiovascular deaths will be adjudicated by an independent blinded endpoint committee.
From randomization through 12 months
Number of Participants With Nonfatal Myocardial Infarction
Délai: From randomization through 12 months
Nonfatal myocardial infarction is defined according to the prespecified clinical, electrocardiographic, imaging, and cardiac biomarker criteria in the study protocol. Participants with at least one confirmed nonfatal myocardial infarction will be counted once.
From randomization through 12 months
Number of Participants Hospitalized for Heart Failure
Délai: From randomization through 12 months
Heart failure hospitalization is defined as an unplanned hospital admission primarily due to signs or symptoms of heart failure that requires initiation or intensification of heart failure treatment. Participants with at least one confirmed hospitalization will be counted once.
From randomization through 12 months
Change From Baseline in the Adherence to Refills and Medications Scale Total Score
Délai: Baseline and 3, 6, and 12 months after randomization
Medication adherence will be assessed using the 12-item Adherence to Refills and Medications Scale. Each item is scored from 1 to 4, producing a total score ranging from 12 to 48. Lower scores indicate better medication adherence. Change from baseline will be calculated as the follow-up score minus the baseline score.
Baseline and 3, 6, and 12 months after randomization
Change From Baseline in the National Institutes of Health Stroke Scale Total Score
Délai: Baseline and 3, 6, and 12 months after randomization
Neurological impairment will be assessed using the National Institutes of Health Stroke Scale. Total scores range from 0 to 42, with higher scores indicating greater neurological impairment. Change from baseline will be calculated as the follow-up score minus the baseline score.
Baseline and 3, 6, and 12 months after randomization
Modified Rankin Scale Score
Délai: At 3, 6, and 12 months after randomization
Global functional status will be assessed using the modified Rankin Scale. Scores range from 0 to 6, where 0 indicates no symptoms, 5 indicates severe disability, and 6 indicates death. Higher scores indicate worse functional outcomes. The distribution of scores will be compared between the study groups.
At 3, 6, and 12 months after randomization
Percentage of Participants With Functional Independence
Délai: At 3, 6, and 12 months after randomization
Functional independence is defined as a modified Rankin Scale score of 0 to 2. The outcome will be reported as the percentage of participants meeting this definition at each follow-up visit.
At 3, 6, and 12 months after randomization
Change From Baseline in the EQ-5D Index Score
Délai: Baseline and 3, 6, and 12 months after randomization
Health-related quality of life will be assessed using the prespecified version of the EQ-5D instrument. Health states will be converted to an index score using the prespecified Chinese population value set. Higher index scores indicate better health-related quality of life. Change from baseline will be calculated as the follow-up score minus the baseline score.
Baseline and 3, 6, and 12 months after randomization
Change From Baseline in the EQ Visual Analogue Scale Score
Délai: Baseline and 3, 6, and 12 months after randomization
Participants will rate their overall health using the EQ Visual Analogue Scale, which ranges from 0 to 100. A score of 0 represents the worst imaginable health and a score of 100 represents the best imaginable health. Change from baseline will be calculated as the follow-up score minus the baseline score.
Baseline and 3, 6, and 12 months after randomization
Change From Baseline in the Patient Health Questionnaire-9 Total Score
Délai: Baseline and 3, 6, and 12 months after randomization
Depressive symptoms will be assessed using the 9-item Patient Health Questionnaire. Total scores range from 0 to 27, with higher scores indicating greater severity of depressive symptoms. Change from baseline will be calculated as the follow-up score minus the baseline score.
Baseline and 3, 6, and 12 months after randomization
Change From Baseline in the Generalized Anxiety Disorder-7 Total Score
Délai: Baseline and 3, 6, and 12 months after randomization
Anxiety symptoms will be assessed using the 7-item Generalized Anxiety Disorder scale. Total scores range from 0 to 21, with higher scores indicating greater severity of anxiety symptoms. Change from baseline will be calculated as the follow-up score minus the baseline score.
Baseline and 3, 6, and 12 months after randomization
Percentage of Participants Who Currently Smoke
Délai: Baseline and 12 months after randomization
Current smoking will be determined using the prespecified lifestyle questionnaire. The definition of current smoking, including the type and frequency of tobacco use and the applicable reference period, will be specified before enrollment.
Baseline and 12 months after randomization
Mean Daily Step Count
Délai: During prespecified 7-day monitoring periods at baseline and 3, 6, and 12 months after randomization
Daily step count will be measured using the study wearable device. The mean daily step count will be calculated using data collected during a prespecified valid monitoring window. A valid day will require at least 10 hours of device wear, and participants must have at least 4 valid days during each assessment window.
During prespecified 7-day monitoring periods at baseline and 3, 6, and 12 months after randomization
Mean Daily Moderate-to-Vigorous Physical Activity Duration
Délai: During prespecified 7-day monitoring periods at baseline and 3, 6, and 12 months after randomization
Moderate-to-vigorous physical activity will be estimated using the study wearable device and the prespecified device algorithm. The mean number of minutes per valid monitoring day will be calculated during each assessment window.
During prespecified 7-day monitoring periods at baseline and 3, 6, and 12 months after randomization
Mean Daily Sedentary Time
Délai: During prespecified 7-day monitoring periods at baseline and 3, 6, and 12 months after randomization
Sedentary time will be estimated using the study wearable device and the prespecified device algorithm. The mean number of sedentary minutes per valid monitoring day will be calculated during each assessment window.
During prespecified 7-day monitoring periods at baseline and 3, 6, and 12 months after randomization
Mean Nightly Sleep Duration
Délai: During prespecified 7-night monitoring periods at baseline and 3, 6, and 12 months after randomization
Sleep duration will be estimated using the study wearable device and the prespecified sleep-detection algorithm. Mean nightly sleep duration will be calculated using nights with valid device recordings during each assessment window.
During prespecified 7-night monitoring periods at baseline and 3, 6, and 12 months after randomization

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Affiliated Hospital of Nantong University

Les enquêteurs

  • Chaise d'étude: Qiuhong Ji, Affiliated Hospital of Nantong University

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

1 septembre 2026

Achèvement primaire (Estimé)

1 septembre 2028

Achèvement de l'étude (Estimé)

30 juin 2029

Dates d'inscription aux études

Première soumission

6 septembre 2026

Première soumission répondant aux critères de contrôle qualité

13 septembre 2026

Première publication (Réel)

17 septembre 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

17 septembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

13 septembre 2026

Dernière vérification

1 août 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • 2026-K241-01

Plan pour les données individuelles des participants (IPD)

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Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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