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 .
Targets and self-management for the control of blood pressure in stroke and at risk groups (TASMIN-SR): protocol for a randomised controlled trial
Background Self-monitoring of hypertension with self-titration of antihypertensives ( self-management ) results in lower systolic blood pressure for at least one year . However , few people in high risk groups have been evaluated to date and previous work suggests a smaller effect size in these groups . This trial therefore aims to assess the added value of self-management in high risk groups over and above usual care . Methods / Design The targets and self-management for the control of blood pressure in stroke and at risk groups ( TASMIN-SR ) trial will be a pragmatic primary care based , unblinded , r and omised controlled trial of self-management of blood pressure ( BP ) compared to usual care .  Eligible patients will have a history of stroke , coronary heart disease , diabetes or chronic kidney disease and will be recruited from primary care . Participants will be individually r and omised to either usual care or self-management . The primary outcome of the trial will be difference in office SBP between intervention and control groups at 12 months adjusted for baseline SBP and covariates . 540 patients will be sufficient to detect a difference in SBP between self-management and usual care of 5 mmHg with 90 % power . Secondary outcomes will include self-efficacy , lifestyle behaviours , health-related quality of life and adverse events . An economic analysis will consider both within trial costs and a model extrapolating the results thereafter . A qualitative analysis will gain insights into patients ’ views , experiences and decision making processes . Discussion The results of the trial will be directly applicable to primary care in the UK . If successful , self-management of blood pressure in people with stroke and other high risk conditions would be applicable to many hundreds of thous and s of individuals in the UK and beyond . Trial Registration IS RCT
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 .