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 .
Outcomes of the Kaiser Permanente Tele-Home Health Research Project.
CONTEXT Level of acuity and number of referrals for home health care have been escalating exponentially . As referrals continue to increase , health care organizations are encouraged to find more effective methods for providing high- quality patient care with cost savings . OBJECTIVE To evaluate the use of remote video technology in the home health care setting as well as the quality , use , patient satisfaction , and cost savings from this technology . DESIGN Quasi-experimental study conducted from May 1996 to October 1997 . SETTING Home health department in the Sacramento , Calif , facility of a large health maintenance organization . PARTICIPANTS Newly referred patients diagnosed as having congestive heart failure , chronic obstructive pulmonary disease , cerebral vascular accident , cancer , diabetes , anxiety , or need for wound care were eligible for r and om assignment to intervention ( n = 102 ) or control ( n = 110 ) groups . INTERVENTION The control and intervention groups received routine home health care ( home visits and telephone contact ) . The intervention group also had access to a remote video system that allowed nurses and patients to interact in real time . The video system included peripheral equipment for assessing cardiopulmonary status . MAIN OUTCOME MEASURES Three quality indicators ( medication compliance , knowledge of disease , and ability for self-care ) ; extent of use of services ; degree of patient satisfaction as reported on a 3-part scale ; and direct and indirect costs of using the remote video technology .  RESULTS No differences in the quality indicators , patient satisfaction , or use were seen . Although the average direct cost for home health services was $ 1830 in the intervention group and $ 1167 in the control group , the total mean costs of care , excluding home health care costs , were $ 1948 in the intervention group and $ 2674 in the control group . CONCLUSIONS Remote video technology in the home health care setting was shown to be effective , well received by patients , capable of maintaining quality of care , and to have the potential for cost savings . Patients seemed pleased with the equipment and the ability to access a home health care provider 24 hours a day . Remote technology has the potential to effect cost savings when used to substitute some in-person visits and can also improve access to home health care staff for patients and caregivers . This technology can thus be an asset for patients and providers
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 .