- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT05963828
Gestione completa della popolazione ad alto rischio di ictus basata sui social network (COMPLIANCE-MT)
Gestione completa della popolazione ad alto rischio di ictus basata sulla rete sociale: uno studio controllato multicentrico, parallelo e randomizzato
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
L'ictus è la principale causa di morte tra i residenti in Cina, con le caratteristiche di alta morbilità, alta mortalità, alto tasso di disabilità, alto tasso di recidiva e così via, che comporta un enorme onere economico per le famiglie e la società dei pazienti. Il rafforzamento della gestione globale della popolazione ad alto rischio di ictus, il miglioramento della compliance terapeutica dei pazienti e il tasso di controllo dei fattori di rischio di ictus svolgono un ruolo chiave nella riduzione delle recidive di ictus.
Questo studio è uno studio multicentrico, prospettico, randomizzato, in singolo cieco, che mira a utilizzare lo strumento dei Mini Programmi WeChat per realizzare la gestione del follow-up post-ospedaliero della popolazione ad alto rischio di ictus. Il tempo di follow-up è di 12 mesi. Il principale risultato della misurazione è stato il cambiamento della compliance terapeutica dei pazienti dopo una gestione completa.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
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Shanghai Municipality
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Shanghai, Shanghai Municipality, Cina, 200433
- Changhai Hospital
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Criterio di inclusione:
- Età ≥18 anni
- Popolazione ad alto rischio di ictus per il ricovero
- Punteggio della scala Rankin modificata ≤ 2
- I pazienti o il caregiver primario hanno smart phone e account wechat
- I pazienti assumono almeno un farmaco per lungo tempo (farmaci antiipertensivi, ipoglicemizzanti, ipolipemizzanti, anticoagulanti, antipiastrinici)
- Consenso informato scritto
Criteri di esclusione:
- I pazienti e le loro famiglie non sono in grado di utilizzare gli smartphone
- Avere altre malattie che interferiscono con la valutazione clinica di follow-up (come cancro, demenza, grave malattia mentale, ecc.)
- L'aspettativa di vita è inferiore a 12 mesi
- Pazienti che vivono in assenza di condizioni di rete
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Prevenzione
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
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Altro: conventional care group
Patients are managed according to the conventional methods after enrollment.
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Patients in conventional care group will receive standardized education based on ASA/AHA 2021 guidelines prior to discharge,2 delivered verbally by a certified Brain-Heart Health Manager (BHHM) and supplemented with an expert-reviewed booklet.
Content will cover medication adherence, risk factor control, stroke recognition, emergency response, and follow-up plans.
A contact number will be provided for post-discharge support.
A baseline archive will document demographics, lifestyle, and cardiovascular risk factors.
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Sperimentale: Social network-based intervention group
Patients are managed according to to the integrated digital platform
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Participants in Social network-based intervention group are onboard to the integrated digital platform.
BHHMs facilitate the activation of the digital interface via a unique QR code, assist in the creation of a comprehensive electronic health record (EHR), and guide participants through an interactive tutorial to ensure technical proficiency in data entry and communication features.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Good Medication Adherence to all guideline-recommended vascular prevention medications at 12 months post-discharge
Lasso di tempo: 12 months post-discharge
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Adherence is assessed using self-reported data, with participants asked to indicate the number of days they missed taking a dose for each medication class during the preceding 30 days. This evaluation is conducted separately for each of the five evidence-based secondary prevention drug classes: antihypertensives, hypoglycemics, lipid-lowering agents, anticoagulants, and antiplatelets. Good adherence for each class is defined as taking the prescribed medication on more than 24 days out of the previous 30 days (corresponding to an adherence rate >80%). To meet the primary endpoint, a participant must achieve this >80% adherence threshold simultaneously across all five medication classes at the 12-month follow-up. Any self-directed cessation or adjustment of the regimen without medical consultation is categorized as non-adherence. Conversely, patients who cease or adjust their medications according to medical advice will be considered adherent. For those who adjust their medications base |
12 months post-discharge
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Proportion of good medication adherence to stroke prevention drugs post-discharge
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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Assessed using the Morisky-8 Medication Adherence Scale [MMAS-8].
Good adherence is defined as an MMAS-8 score greater than 6.The lowest score is 0, and the highest score is 8.
A higher score indicates better adherence.
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1 month, 3 months, 6 months and 12 months post-discharge
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Risk factor control, including blood glucose(mmol/L), blood pressure(mmHg), lipid profile(mmol/L), body mass index (BMI) (kg/m ^ 2), waist circumference(cm), hip circumference(cm), and smoking status post-discharge.
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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The method of measurement is as follows: Blood lipids(mmol/L): fasting blood sampling measurement Blood glucose(mmol/L): fasting fingertip blood glucose Blood pressure(mmHg): using a sphygmomanometer to measure BMI (kg/m ^ 2): weight(kg) / height (m ^ 2) Waist circumference(cm), Hip circumference(cm), Smoking: Patient self-report |
1 month, 3 months, 6 months and 12 months post-discharge
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Health-related quality of life (HRQoL)
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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Assessed using the EuroQol Five-Dimension Five-Level Scale (EQ-5D-5L),including visual analog scale (score range of 0-100, higher score indicates better health status) and utility score (score range of[ -0.391,1], higher score indicates better quality of life for patients)
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1 month, 3 months, 6 months and 12 months post-discharge
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Anxiety symptom severity
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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assessed using the 7-item Generalized Anxiety Disorder Scale (GAD-7),the score range is 0-21 points, with higher scores indicating greater levels of anxiety.
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1 month, 3 months, 6 months and 12 months post-discharge
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Depressive symptom severity
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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Assessed using the 9-item Patient Health Questionnaire (PHQ-9),the score range is 0-27 points, with higher scores indicating more severe depression.
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1 month, 3 months, 6 months and 12 months post-discharge
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Stroke prevention knowledge scores
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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Assessed using the Stroke Prevention Knowledge Questionnaire,the score range is 0-36 points, with higher scores indicating better mastery of stroke related knowledge.
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1 month, 3 months, 6 months and 12 months post-discharge
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Personal motivation for stroke prevention
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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Assessed using the Stroke Attitude Questionnaire,the total score is the sum of 16 items, and the higher the score, the better the cognitive attitude.
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1 month, 3 months, 6 months and 12 months post-discharge
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Perceived social support
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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Assessed using the Perceived Social Support Scale (PSSS),there are a total of 12 items, with each item assigned a score of 1-7, for a total score of 12-84.
The higher the score, the higher the individual's level of social support.
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1 month, 3 months, 6 months and 12 months post-discharge
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Stroke prevention-related health behavior scores
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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Assessed using the Stroke Prevention Health Behavior Scale,the scale consists of 25 items and uses the Likert 4-point scoring method.
The higher the total score, the higher the level of healthy behavior.
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1 month, 3 months, 6 months and 12 months post-discharge
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Self-efficacy for chronic disease management
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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Assessed using the Chronic Disease Self-Efficacy Scale,the scale consists of 6 items, with each item rated on a scale of 1-10.
The average score is taken, and the higher the average score, the stronger the self-efficacy.
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1 month, 3 months, 6 months and 12 months post-discharge
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Intentions regarding prehospital delay in stroke emergency care
Lasso di tempo: 1 month, 3 months, 6 months and 12 months post-discharge
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Assessed using the Prehospital Delay Behavior Intention Scale for Stroke,the scale consists of 27 items and uses the Likert 5-point scoring method, with a score range of 27-135 points.
The higher the score, the stronger the intention and likelihood of delaying medical treatment.
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1 month, 3 months, 6 months and 12 months post-discharge
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Incidence of major adverse cerebrovascular and cardiovascular events (MACCE)
Lasso di tempo: 1month, 3months, 6months and 12-months post-discharge
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Including stroke, acute coronary syndrome, and vascular death
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1month, 3months, 6months and 12-months post-discharge
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Collaboratori e investigatori
Sponsor
Investigatori
- Direttore dello studio: Zhang lingjuan, Changhai Hospital Affiliated to Naval Medical University
Pubblicazioni e link utili
Pubblicazioni generali
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- Zhang T, Zhao J, Li X, Bai Y, Wang B, Qu Y, Li B, Zhao S; Chinese Stroke Association Stroke Council Guideline Writing Committee. Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of stroke rehabilitation. Stroke Vasc Neurol. 2020 Sep;5(3):250-259. doi: 10.1136/svn-2019-000321. Epub 2020 Jun 28.
- Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jimenez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation. 2017 Mar 7;135(10):e146-e603. doi: 10.1161/CIR.0000000000000485. Epub 2017 Jan 25. No abstract available.
- GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov 10;392(10159):1789-1858. doi: 10.1016/S0140-6736(18)32279-7. Epub 2018 Nov 8.
- Morawski K, Ghazinouri R, Krumme A, Lauffenburger JC, Lu Z, Durfee E, Oley L, Lee J, Mohta N, Haff N, Juusola JL, Choudhry NK. Association of a Smartphone Application With Medication Adherence and Blood Pressure Control: The MedISAFE-BP Randomized Clinical Trial. JAMA Intern Med. 2018 Jun 1;178(6):802-809. doi: 10.1001/jamainternmed.2018.0447.
- Xu, A.D. Building a bridge between guidelines and practice to standardize secondary prevention of ischemic stroke/transient ischemic attack in China [J].Stroke,20105(6):429-430. https://doi.org/10.3969/j.issn.1673-5765.2010.06.002
- Bridgwood B, Lager KE, Mistri AK, Khunti K, Wilson AD, Modi P. Interventions for improving modifiable risk factor control in the secondary prevention of stroke. Cochrane Database Syst Rev. 2018 May 7;5(5):CD009103. doi: 10.1002/14651858.CD009103.pub3.
- Chen, W. W., Gao, R. L., Liu, L. S., et al.Summary of the 2017 China Cardiovascular Disease Report[J]. Chinese Circulation Journal,2018,33(1):1-8.
- National Health Commission of the People's Republic of China. Management Measures for the Pilot Program on Screening and Intervention for High-RiskPopulations of Apoplexy (Trial)[EB/OL].[2023-06-28].http://www.nhc.gov.cn/wjw/gfxwj/201304/3dca42b696ad411da36e8b5b9321 d8e3.shtml.
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- Zhao Q, Yang L, Zuo Q, Zhu X, Zhang X, Wu Y, Yang L, Gao W, Li M. Instrument development and validation of the stroke pre-hospital delay behavior intention scale in a Chinese urban population. Health Qual Life Outcomes. 2014 Nov 29;12:170. doi: 10.1186/s12955-014-0170-8.
- Li-Hong W,Xiao-Ni X,Jun-Hao P,et al.Development and reliability and validity testing of the Stroke Patients' Healthy Behavior Scale[J].Journal of Nursing,2017,32 (1):25-29.
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- Wan LH, Zhang XP, Hong H, et al. Health behaviors of stroke patients and their influencing factors[J]. Chinese Nursing Research, 2010, 24(1):1-4.
- EuroQol Research Foundation. EQ-5D-5L User Guide, Version 4.0[EB/OL]. (2025-08).
- Li DM, Lu XY, Yang PF, Zheng J, Hu HH, Zhou Y, Zhang LJ, Liu JM. Coordinated Patient Care via Mobile Phone-Based Telemedicine in Secondary Stroke Prevention: A Propensity Score-Matched Cohort Study. J Nurs Care Qual. 2023 Jul-Sep 01;38(3):E42-E49. doi: 10.1097/NCQ.0000000000000693. Epub 2023 Feb 24.
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- COMPLIANCE-MT
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Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .