Digital health tools empower stroke healthcare
As the leading cause of disability and deaths globally, strokes have significant impact on paitient and the healthcare system.
Stroke prevention, while underprovided in most countries, is lacking when resources are limited and health services are inadequate. Insufficient stroke management not only leads to recurrence of stroke, disabilities and deaths, but also bring a significant burden to the healthcare system.
Enying Gong, the PhD candidate at Nossal institute, has been contributing to a model of care to improve the health of stroke patients . The SINEMA project, led by Prof. Lijing Yan from the Duke Kunshan University and Prof. Brian Oldenburg, promotes the task-shift and task-sharing between primary healthcare providers and specialists. Stroke survivors received regular follow-up visits from their village doctors along with voice messages to improve their self-management and rehabilitation.
The SINEMA program was implemented and evaluated by a cluster-randomized controlled trial involving 1299 stroke patients in 50 rural villages in China. The intervention increased the blood pressure control among stroke survivors, improved medication adherence, quality of life, reduced disabilities, stroke recurrence and mortality over 12 months compared with the group who received usual care.
I’m excited with the results. These findings have the potential to be scaled up into other settings and for other chronic disease management. Enying Gong
The findings show strengthening the primary healthcare system could be crucial in combatting the increasing burden of stroke and highlights the effectiveness of task-shifting and task-sharing. The results demonstrate the potential of using digital health tools to empower healthcare providers and patients.
The study was funded by the United Kingdom Medical Research Council, Economic and Social Research Council, Department for International Development, and Wellcome Trust (Grant No: MR/N015967/1). Enying Gong is supported by the Melbourne Graduate Scholarship.
Some other publications related to this study
1. Gong, E., Gu, W., Sun, C., Turner, E. L., Zhou, Y., Li, Z., Bettger, JP., Oldenburg, B., Amaya-Burns A., Wang Y, Xu LQ., Yao J., Dong, D., Xu Z., Li C, Hou, M., Yan LL. (2019). System-integrated technology-enabled model of care to improve the health of stroke patients in rural China: protocol for SINEMA—a cluster-randomized controlled trial. American Heart Journal, 207, 27-39.
2. Gong, E., Yan, L.L., McCormack, K., Gallis, J.A., Bettger, J.P. and Turner, E.L., 2019. System-integrated technology-enabled model of care (SINEMA) to improve the health of stroke patients in rural China: Statistical analysis plan for a cluster-randomized controlled trial. International Journal of Stroke, 2020, 15 (2), 226-230
3. Wu, Na, Enying Gong, Bo Wang, Wanbing Gu, Nan Ding, Zhuoran Zhang, Mengyao Chen, Lijing L. Yan, Brian Oldenburg, and Li-Qun Xu. “A Smart and Multifaceted Mobile Health System for Delivering Evidence-Based Secondary Prevention of Stroke in Rural China: Design, Development, and Feasibility Study.” JMIR mHealth and uHealth, 2019;7 (7): e13503.
4. Gong E., Gu W, Luo E, Tan L, Donovan J., Sun C., Yang Y., Zang L., Bao P., Yan LL. Development and Local Contextualization of mHealth Messages for Enhancing Disease Management among Community-dwelling Stroke Patients in Rural China: Multimethod Study. JMIR mhealth uhealth, 2019;7(12):e15758