Coordinated Patient Care via Mobile Phone-Based Telemedicine in Secondary Stroke Prevention: A Propensity Score-Matched Cohort Study

Abstract

Background: To prevent recurrent stroke, patients need to follow evidence-based practices following discharge; however, adherence to these practices is suboptimal. Purpose: To evaluate whether a smartphone mobile application can improve medication adherence and stroke awareness in secondary stroke prevention. Methods: A retrospective study design was used. Patients with ischemic stroke registered in a database between August 2018 and January 2019 were enrolled. Propensity score matching was used to match patients managed with the mobile application compared with regular practice in a 1:2 ratio. Results: Sixty-five patients were paired with 123 controls. Three-month medication adherence was 93.8% in the application group versus 82.9% in the control group (P =.036). Patients in the application group were more likely to know stroke warning signs (P =.003) and when to call an ambulance for stroke symptoms (87.7% vs 72.4%, P =.016). Conclusions: Using a mobile application may increase medication adherence and stroke awareness in secondary stroke prevention.