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 .
Randomized Controlled Trial of a Multipronged Intervention to Improve Blood Pressure Control among Stroke Survivors in Nigeria
Rationale Stroke is the second-leading cause of death in low- and middle-income countries , but use of evidence -based therapies for stroke prevention in such countries , especially those in Africa , is extremely poor . This study is design ed to enhance the implementation and sustainability of secondary stroke-preventive services following hospital discharge . Aim /Hypothesis The primary study aim is to test whether a Chronic Care Model-based initiative entitled the Tailored Hospital-based Risk reduction to Impede Vascular Events after Stroke ( THRIVES ) significantly improves blood pressure control after stroke . Design This prospect i ve triple-blind r and omized controlled trial will include a cohort of 400 patients with a recent stroke discharged from four medical care facilities in Nigeria . The culturally sensitive , system-appropriate intervention comprises patient report cards , phone text messaging , an educational video , and coordination of posthospitalization care . Study Outcomes The primary outcome is improvement of blood pressure control . Secondary endpoints include control of other stroke risk factors , medication adherence , functional status , and quality of life . We will also perform a cost analysis of THRIVES from the viewpoint of government policy-makers . Discussion We anticipate that a successful intervention will serve as a scalable model of effective postdischarge chronic blood pressure management for stroke in sub-Saharan Africa and possibly for other symptomatic cardiovascular disease entities in the region
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 .