title: The NAILED stroke risk factor trial (nurse based age independent intervention to limit evolution of disease after stroke): study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Secondary prevention after stroke and transient ischemic attack (TIA) is essential in order to reduce morbidity and mortality. Secondary stroke prevention studies have, however, been fairly small, or performed as clinical trials with non-representative patient selection. Long-term follow-up data is also limited. A nurse-led follow-up for risk factor improvement may be effective but the evidence is limited. The aims of this study are to perform an adequately sized, nurse-led, long-term secondary preventive follow-up with a population-based inclusion of stroke and TIA patients. The focus will be on blood pressure and lipid control as well as tobacco use and physical activity.
  
  
  METHODS
  A randomized, controlled, long-term, population-based trial with two parallel groups. The patients will be included during the initial hospital stay. Important outcome variables are sitting systolic and diastolic blood pressure, LDL cholesterol and total cholesterol. Outcomes will be measured after 12, 24 and 36 months of follow-up. Trained nurses will manage the intervention group with a focus on reaching set treatment goals as soon as possible. The control group will receive usual care. At least 200 patients will be included in each group, in order to reliably detect a difference in mean systolic blood pressure of 5 mmHg. This sample size is also adequate for detection of clinically meaningful group differences in the other outcomes.
  
  
  CONCLUSIONS
  This study will test the hypothesis that a nurse-led, long-term follow-up after stroke with a focus on reaching set treatment goals as soon as possible, is an effective secondary preventive method. If proven effective, this method could be implemented in general practice at a low cost.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN23868518.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Östersund, Sweden. thomas.mooe@medicin.umu.se
authors.forename: Thomas
authors.initials: T
authors.lastname: Mooe
authors.forename: Lisa
authors.initials: L
authors.lastname: Bergström
authors.forename: Anna-Lotta
authors.initials: AL
authors.lastname: Irewall
authors.forename: Joachim
authors.initials: J
authors.lastname: Ogren
mesh_terms: D000367:Age Factors; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002985:Clinical Protocols; D018450:Disease Progression; D015444:Exercise; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology / Q000451:nursing*; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention / Q000379:methods*; D016540:Smoking Cessation; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000451:nursing*; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents