Mobile health intervention can help prevent secondary stroke: ICMR

The trial was conducted as part of the Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (Sprint-India) which was a multicenter, randomized-controlled trial of a semi-interactive mobile health intervention among stroke patients across 31 stroke centres in India.

A total of 4,298 patients were randomly allocated to the intervention arm (2148) and control arm (2150). 1502 patients in the intervention arm and 1536 patients in the control arm completed 1 year follow-up.

The trial’s intervention was a package composed of SMS text messages, health education videos and stroke prevention workbook for patients. The messages focused on controlling blood sugar, blood pressure, cholesterol, improving physical activity, eating a healthy diet and not to miss taking medicines to prevent stroke.

Stroke (brain attack) is one of the leading causes of death and disability in India. There are two types of stroke; ischemic when there is a blockage in one of the brain arteries and brain hemorrhage when there is rupture and leakage of one of the arteries which supplies blood to the brain.

Dr Jeyaraj D Pandian, professor of neurology and principal, Christian Medical College, Ludhiana who is the principal investigator of the clinical coordinating centre for the trial said that the proportion of patients who stopped smoking (83%) and alcohol (85%) improved in the intervention group as compared to control group (78% and 75% respectively). 

Adherence to medications was also better in the intervention arm (94%) as compared to the control arm (89%). The events like stroke, heart attack and death did not differ between the two groups (5.5% vs 4.9%) at one year follow up. This may be because the follow up period was too short or study centers were stroke-ready centers, which were already providing good quality of care to stroke patients. The findings of SPRINT India trial have a long-term benefit for patients who had a stroke through mobile health interventions.

Dr Meenakshi Sharma Scientist-G, Noncommunicable Diseases Division, ICMR stated that two-stroke clinical trials were completed in the ICMR’s INSTRuCT network phase I (5 years). She informed that SPRINT study is the first trial in India (and perhaps globally) to try to assess the role of an mHealth intervention in secondary prevention of stroke at such a large scale. It provides hope in improving lifestyle and medical complications leveraging technology in a resource-constrained setup. In phase 2 which started in September 2022, 4 more stroke trials, which are very relevant to the country, have been initiated by ICMR. We would get answers to important treatments for stroke in the coming years.

The awareness material was systematically developed in 12 different regional languages. The patients in the control group received standard care whereas those in the intervention arm received awareness material at weekly intervals to promote healthy living and adherence to medicines. The results of the study have now been published in the latest issue of Lancet Journal.

The trial was conducted as part of the Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (Sprint-India) which was a multicenter, randomized-controlled trial of a semi-interactive mobile health intervention among stroke patients across 31 stroke centres in India.

A total of 4,298 patients were randomly allocated to the intervention arm (2148) and control arm (2150). 1502 patients in the intervention arm and 1536 patients in the control arm completed 1 year follow-up.

The trial’s intervention was a package composed of SMS text messages, health education videos and stroke prevention workbook for patients. The messages focused on controlling blood sugar, blood pressure, cholesterol, improving physical activity, eating a healthy diet and not to miss taking medicines to prevent stroke.

Stroke (brain attack) is one of the leading causes of death and disability in India. There are two types of stroke; ischemic when there is a blockage in one of the brain arteries and brain hemorrhage when there is rupture and leakage of one of the arteries which supplies blood to the brain.

Dr Jeyaraj D Pandian, professor of neurology and principal, Christian Medical College, Ludhiana who is the principal investigator of the clinical coordinating centre for the trial said that the proportion of patients who stopped smoking (83%) and alcohol (85%) improved in the intervention group as compared to control group (78% and 75% respectively). 

Adherence to medications was also better in the intervention arm (94%) as compared to the control arm (89%). The events like stroke, heart attack and death did not differ between the two groups (5.5% vs 4.9%) at one year follow up. This may be because the follow up period was too short or study centers were stroke-ready centers, which were already providing good quality of care to stroke patients. The findings of SPRINT India trial have a long-term benefit for patients who had a stroke through mobile health interventions.

Dr Meenakshi Sharma Scientist-G, Noncommunicable Diseases Division, ICMR stated that two-stroke clinical trials were completed in the ICMR’s INSTRuCT network phase I (5 years). She informed that SPRINT study is the first trial in India (and perhaps globally) to try to assess the role of an mHealth intervention in secondary prevention of stroke at such a large scale. It provides hope in improving lifestyle and medical complications leveraging technology in a resource-constrained setup. In phase 2 which started in September 2022, 4 more stroke trials, which are very relevant to the country, have been initiated by ICMR. We would get answers to important treatments for stroke in the coming years.

The awareness material was systematically developed in 12 different regional languages. The patients in the control group received standard care whereas those in the intervention arm received awareness material at weekly intervals to promote healthy living and adherence to medicines. The results of the study have now been published in the latest issue of Lancet Journal.