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Does behaviour modification affect post-stroke risk factor control? Three-year follow-up of a randomized controlled trial

Department of Geriatric Medicine, Gartnavel General Hospital, Glasgow, juliemcmanus1{at}hotmail.com

Alison Craig

Department of Geriatric Medicine, Monklands District General Hospital, Airdrie

Christine McAlpine

Department of Geriatric Medicine, Stobhill Hospital, Glasgow

Peter Langhorne

Academic Section of Geriatric Medicine, University Block, Glasgow Royal Infirmary

Graham Ellis

Department of Geriatric Medicine, Monklands District General Hospital, Airdrie, UK

Objective: Little is known about the long-term effectiveness after stroke of interventions for behaviour modification and ensuring concordance with therapies. We describe a follow-up study of a previous randomized controlled trial of a brief period of behaviour modification. The aim of this study was to determine outcomes three years after the initial intervention.

Design: Survivors of the original cohort were contacted and asked to attend for follow-up interview, within a geriatric day hospital. This study was carried out in the Geriatric Day Hospital at Stobhill Hospital, Balornock Road, Glasgow.

Interventions: Details of risk factor control, including blood pressure, cholesterol levels and diabetic control, were assessed. Questionnaires used in the initial study were repeated including the Geriatric Depression Scale score, Euroqol Perceived Health Status and Stroke Services Satisfaction Questionnaire.

Main measures: Primary outcome was collective risk factor control. Clinical outcomes including recurrent cerebrovascular events, medication persistence and perceived health status were also recorded.

Results: Mean length of follow-up was 3.6 years (SD 0.43). Of the 205 patients enrolled in the initial study, 102 patients attended for repeat interview

(49 intervention/53 control). There were no significant differences in the percentage of controlled risk factors between groups (intervention 51.7% versus control 55.9%, P = 0.53). Similarities were observed in the number of recurrent clinical events and medication persistence between groups. No overall difference was observed in perceived health status, satisfaction with care or depression scores.

Conclusions: Brief intervention with respect to behaviour modification and risk factor control does not appear to have any long-term benefit. These results must be cautiously interpreted in light of the small study number and further research is required.

This version was published on February 1, 2009

Clinical Rehabilitation, Vol. 23, No. 2, 99-105 (2009)
DOI: 10.1177/0269215508095874


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