There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .
Center for stroke disparities solutions community- based care transition interventions: study protocol of a randomized controlled trial
Background Racial and ethnic disparities persist in stroke occurrence , recurrence , morbidity and mortality . Uncontrolled hypertension ( HTN ) is the most important modifiable risk factor for stroke risk . Home health care organizations care for many patients with uncontrolled HTN and history of stroke ; however , recurrent stroke prevention has not been a home care priority . We are conducting a r and omized controlled trial ( RCT ) to compare the effectiveness , relative to usual home care ( UHC ) , of two Community Transitions Interventions ( CTIs ) . The CTIs aim to reduce recurrent stroke risk among post-stroke patients via home-based transitional care focused on better HTN management . Methods / Design This 3-arm trial will r and omly assign 495 black and Hispanic post-stroke home care patients with uncontrolled systolic blood pressure ( SBP ) to one of three arms : UHC , UHC complemented by nurse practitioner-delivered transitional care ( UHC + NP ) or UHC complemented by an NP plus health coach ( UHC + NP + HC ) . Both intervention arms emphasize : 1 ) linking patients to continuous , responsive preventive and primary care , 2 ) increasing patients ’ /caregivers ’ ability to manage a culturally and individually tailored BP reduction plan , and 3 ) facilitating the patient ’s reintegration into the community after home health care discharge . The primary hypothesis is that both NP-only and NP + HC transitional care will be more effective than UHC alone in achieving a SBP reduction . The primary outcome is change in SPB at 3 and 12 months . The study also will examine cost-effectiveness , quality of life and moderators ( for example , race/ethnicity ) and mediators ( for example , changes in health behaviors ) that may affect treatment outcomes . All outcome data are collected by staff blinded to group assignment . Discussion This study targets care gaps affecting a particularly vulnerable black/Hispanic population characterized by persistent stroke disparities . It focuses on care transitions , a juncture when patients are particularly susceptible to adverse events . The CTI is innovative in adapting for stroke patients an established transitional care model shown to be effective for HF patients , pairing the professional NP with a HC , implementing a culturally tailored intervention , and placing primary emphasis on longer-term risk factor reduction and community reintegration rather than shorter-term transitional care outcomes .Trial registration Clinical Trials.gov NCT01918891 ; Registered 5 August 2013
There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .