Phone-based Intervention under Nurse Guidance after Stroke (PINGS): study protocol for a randomized controlled trial

Area of Science:

• Neurology
• Public Health
• Digital Health

Background:

• Hypertension is a key modifiable risk factor for recurrent stroke.
• Stroke burden is increasing in Sub-Saharan Africa (SSA).
• Limited data exists on behavioral interventions for post-stroke blood pressure (BP) control in SSA.

Purpose of the Study:

• To evaluate an mHealth technology-enabled, nurse-led intervention for improving BP control in Ghanaian stroke patients.
• To compare the intervention against standard care within one month of stroke onset.
• To assess the feasibility and preliminary effectiveness of the intervention.

Main Methods:

• A two-arm cluster randomized controlled feasibility pilot trial involving 60 recent-stroke survivors.
• Intervention group received a pillbox, BP device, and smartphone for monitoring, with nurse guidance and tailored text messages.
• Standard care for the control group.
• Follow-up for 6 months, with BP control assessed at 3, 6, and 9 months.
• Physician blinding to treatment allocation.

Main Results:

• The study aimed to establish feasibility and preliminary effectiveness.
• Primary outcome: BP control at 3, 6, and 9 months.
• Secondary outcomes: medication adherence and self-regulation scores.
• Qualitative study to explore participant experiences.

Conclusions:

• A feasible and preliminarily effective intervention could support larger trials.
• Potential to reduce stroke-related morbidity and mortality in low- to middle-income countries.
• Highlights the role of mHealth in managing hypertension post-stroke in resource-limited settings.