Preventing recurrence of thromboembolic events through coordinated treatment in the District of Columbia

Alexander W. Dromerick, Michael C. Gibbons, Dorothy F. Edwards, Deeonna E. Farr, Margot L. Giannetti, Brisa Sánchez, Nawar M. Shara, Ali Fokar, Annapurni Jayam-Trouth, Bruce Ovbiagele, Stella Kidwell

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Rationale PROTECT DC examines whether stroke navigators can improve cardiovascular risk factors in urban underserved individuals newly hospitalized for stroke or ischemic attack. Within one-year of hospital discharge, up to one-third of patients no longer adhere to secondary prevention behaviors. Adherence rates are lower in minority-underserved groups, contributing to health disparities. In-hospital programs increase use of stroke prevention therapies but may not be as successful in underserved individuals. In these groups, low literacy, limited healthcare access, and sparse community resources may reduce adherence. Lay community health workers (navigators) improve adherence in other illnesses through education and assisting in overcoming barriers to achieving desired health behaviors and obtaining needed healthcare services. Aims and design PROTECT DC is a Phase II, single-blind, randomized, controlled trial comparing in-hospital education plus stroke navigators to usual care. Atherogenic ischemic stroke and transient ischemic attack survivors are recruited from Washington, DC hospitals. Navigators meet with participants during the index hospitalization, perform home visits, and meet by phone. They focus on stroke education, medication compliance, and overcoming practical barriers to adherence. The interventions are driven by the theories of reasoned action and planned behavior. Study outcomes The primary dependent measure is a summary score of four objective measures of stroke risk factor control: systolic blood pressure, low-density lipoprotein, hemoglobin Hb A1C, and antiplatelet agent pill counts. Secondary outcomes include stroke knowledge, exercise, dietary modification, and smoking cessation. Conclusion PROTECT DC will determine whether a Phase III trial of stroke navigation for urban underserved individuals to improve adherence to secondary stroke prevention behaviors is warranted.

Original languageEnglish (US)
Pages (from-to)454-460
Number of pages7
JournalInternational Journal of Stroke
Volume6
Issue number5
DOIs
StatePublished - Oct 2011
Externally publishedYes

Fingerprint

Stroke
Recurrence
Therapeutics
Secondary Prevention
Education
Blood Pressure
Delivery of Health Care
Diet Therapy
Minority Groups
House Calls
Medication Adherence
Platelet Aggregation Inhibitors
Transient Ischemic Attack
Health Behavior
Smoking Cessation
LDL Lipoproteins
Survivors
Hemoglobins
Hospitalization
Randomized Controlled Trials

Keywords

  • Clinical trials
  • Community health education
  • Health behavior
  • Healthcare disparities
  • Patient adherence
  • Patient compliance
  • Secondary prevention
  • Stroke

ASJC Scopus subject areas

  • Neurology

Cite this

Preventing recurrence of thromboembolic events through coordinated treatment in the District of Columbia. / Dromerick, Alexander W.; Gibbons, Michael C.; Edwards, Dorothy F.; Farr, Deeonna E.; Giannetti, Margot L.; Sánchez, Brisa; Shara, Nawar M.; Fokar, Ali; Jayam-Trouth, Annapurni; Ovbiagele, Bruce; Kidwell, Stella.

In: International Journal of Stroke, Vol. 6, No. 5, 10.2011, p. 454-460.

Research output: Contribution to journalArticle

Dromerick, AW, Gibbons, MC, Edwards, DF, Farr, DE, Giannetti, ML, Sánchez, B, Shara, NM, Fokar, A, Jayam-Trouth, A, Ovbiagele, B & Kidwell, S 2011, 'Preventing recurrence of thromboembolic events through coordinated treatment in the District of Columbia', International Journal of Stroke, vol. 6, no. 5, pp. 454-460. https://doi.org/10.1111/j.1747-4949.2011.00654.x
Dromerick, Alexander W. ; Gibbons, Michael C. ; Edwards, Dorothy F. ; Farr, Deeonna E. ; Giannetti, Margot L. ; Sánchez, Brisa ; Shara, Nawar M. ; Fokar, Ali ; Jayam-Trouth, Annapurni ; Ovbiagele, Bruce ; Kidwell, Stella. / Preventing recurrence of thromboembolic events through coordinated treatment in the District of Columbia. In: International Journal of Stroke. 2011 ; Vol. 6, No. 5. pp. 454-460.
@article{bbb7587581ae4844a6b1d2faa98a2155,
title = "Preventing recurrence of thromboembolic events through coordinated treatment in the District of Columbia",
abstract = "Rationale PROTECT DC examines whether stroke navigators can improve cardiovascular risk factors in urban underserved individuals newly hospitalized for stroke or ischemic attack. Within one-year of hospital discharge, up to one-third of patients no longer adhere to secondary prevention behaviors. Adherence rates are lower in minority-underserved groups, contributing to health disparities. In-hospital programs increase use of stroke prevention therapies but may not be as successful in underserved individuals. In these groups, low literacy, limited healthcare access, and sparse community resources may reduce adherence. Lay community health workers (navigators) improve adherence in other illnesses through education and assisting in overcoming barriers to achieving desired health behaviors and obtaining needed healthcare services. Aims and design PROTECT DC is a Phase II, single-blind, randomized, controlled trial comparing in-hospital education plus stroke navigators to usual care. Atherogenic ischemic stroke and transient ischemic attack survivors are recruited from Washington, DC hospitals. Navigators meet with participants during the index hospitalization, perform home visits, and meet by phone. They focus on stroke education, medication compliance, and overcoming practical barriers to adherence. The interventions are driven by the theories of reasoned action and planned behavior. Study outcomes The primary dependent measure is a summary score of four objective measures of stroke risk factor control: systolic blood pressure, low-density lipoprotein, hemoglobin Hb A1C, and antiplatelet agent pill counts. Secondary outcomes include stroke knowledge, exercise, dietary modification, and smoking cessation. Conclusion PROTECT DC will determine whether a Phase III trial of stroke navigation for urban underserved individuals to improve adherence to secondary stroke prevention behaviors is warranted.",
keywords = "Clinical trials, Community health education, Health behavior, Healthcare disparities, Patient adherence, Patient compliance, Secondary prevention, Stroke",
author = "Dromerick, {Alexander W.} and Gibbons, {Michael C.} and Edwards, {Dorothy F.} and Farr, {Deeonna E.} and Giannetti, {Margot L.} and Brisa S{\'a}nchez and Shara, {Nawar M.} and Ali Fokar and Annapurni Jayam-Trouth and Bruce Ovbiagele and Stella Kidwell",
year = "2011",
month = "10",
doi = "10.1111/j.1747-4949.2011.00654.x",
language = "English (US)",
volume = "6",
pages = "454--460",
journal = "International Journal of Stroke",
issn = "1747-4930",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Preventing recurrence of thromboembolic events through coordinated treatment in the District of Columbia

AU - Dromerick, Alexander W.

AU - Gibbons, Michael C.

AU - Edwards, Dorothy F.

AU - Farr, Deeonna E.

AU - Giannetti, Margot L.

AU - Sánchez, Brisa

AU - Shara, Nawar M.

AU - Fokar, Ali

AU - Jayam-Trouth, Annapurni

AU - Ovbiagele, Bruce

AU - Kidwell, Stella

PY - 2011/10

Y1 - 2011/10

N2 - Rationale PROTECT DC examines whether stroke navigators can improve cardiovascular risk factors in urban underserved individuals newly hospitalized for stroke or ischemic attack. Within one-year of hospital discharge, up to one-third of patients no longer adhere to secondary prevention behaviors. Adherence rates are lower in minority-underserved groups, contributing to health disparities. In-hospital programs increase use of stroke prevention therapies but may not be as successful in underserved individuals. In these groups, low literacy, limited healthcare access, and sparse community resources may reduce adherence. Lay community health workers (navigators) improve adherence in other illnesses through education and assisting in overcoming barriers to achieving desired health behaviors and obtaining needed healthcare services. Aims and design PROTECT DC is a Phase II, single-blind, randomized, controlled trial comparing in-hospital education plus stroke navigators to usual care. Atherogenic ischemic stroke and transient ischemic attack survivors are recruited from Washington, DC hospitals. Navigators meet with participants during the index hospitalization, perform home visits, and meet by phone. They focus on stroke education, medication compliance, and overcoming practical barriers to adherence. The interventions are driven by the theories of reasoned action and planned behavior. Study outcomes The primary dependent measure is a summary score of four objective measures of stroke risk factor control: systolic blood pressure, low-density lipoprotein, hemoglobin Hb A1C, and antiplatelet agent pill counts. Secondary outcomes include stroke knowledge, exercise, dietary modification, and smoking cessation. Conclusion PROTECT DC will determine whether a Phase III trial of stroke navigation for urban underserved individuals to improve adherence to secondary stroke prevention behaviors is warranted.

AB - Rationale PROTECT DC examines whether stroke navigators can improve cardiovascular risk factors in urban underserved individuals newly hospitalized for stroke or ischemic attack. Within one-year of hospital discharge, up to one-third of patients no longer adhere to secondary prevention behaviors. Adherence rates are lower in minority-underserved groups, contributing to health disparities. In-hospital programs increase use of stroke prevention therapies but may not be as successful in underserved individuals. In these groups, low literacy, limited healthcare access, and sparse community resources may reduce adherence. Lay community health workers (navigators) improve adherence in other illnesses through education and assisting in overcoming barriers to achieving desired health behaviors and obtaining needed healthcare services. Aims and design PROTECT DC is a Phase II, single-blind, randomized, controlled trial comparing in-hospital education plus stroke navigators to usual care. Atherogenic ischemic stroke and transient ischemic attack survivors are recruited from Washington, DC hospitals. Navigators meet with participants during the index hospitalization, perform home visits, and meet by phone. They focus on stroke education, medication compliance, and overcoming practical barriers to adherence. The interventions are driven by the theories of reasoned action and planned behavior. Study outcomes The primary dependent measure is a summary score of four objective measures of stroke risk factor control: systolic blood pressure, low-density lipoprotein, hemoglobin Hb A1C, and antiplatelet agent pill counts. Secondary outcomes include stroke knowledge, exercise, dietary modification, and smoking cessation. Conclusion PROTECT DC will determine whether a Phase III trial of stroke navigation for urban underserved individuals to improve adherence to secondary stroke prevention behaviors is warranted.

KW - Clinical trials

KW - Community health education

KW - Health behavior

KW - Healthcare disparities

KW - Patient adherence

KW - Patient compliance

KW - Secondary prevention

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=80053200692&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053200692&partnerID=8YFLogxK

U2 - 10.1111/j.1747-4949.2011.00654.x

DO - 10.1111/j.1747-4949.2011.00654.x

M3 - Article

C2 - 21951411

AN - SCOPUS:80053200692

VL - 6

SP - 454

EP - 460

JO - International Journal of Stroke

JF - International Journal of Stroke

SN - 1747-4930

IS - 5

ER -