title: Tailored interventions to improve hypertension management after stroke or TIA--phase II (TIMS II).
abstract: BACKGROUND
  Reduction of blood pressure (BP) after stroke or TIA decreases stroke recurrence and is a major goal ofsecondary Stroke Prevention Clinics (SPCs). Health care providers need effective screening processes to identify those clients at highest risk of not achieving BP targets and those clients at highest risk ofnon-adherence to medication.
  
  
  METHODS
  This multicentred, randomized controlled study used a screening process to identify SPC patients with psychosocial/cognitive deficits (e.g., lack of confidence in the utility of medications, poor memory, mild cognitive impairment) who were experiencing difficulty managing their BP to target values and evaluated whether a model of nurse-led case management program (monthly telephone calls, motivational interviewingfor lifestyle change, plus home BP monitoring and use ofdosettes for medication administration) would improve BP measures and adherence to medications.
  
  
  RESULTS
  Both intervention (n=29) and usual care groups (n=27) showed a trend-for'reduced BP at six months (Median ql-q3, Systolic BR p=0.46; Diastolic BR p=0.37). Diabetic patients, irrespective of the group to which they were randomized, were less likely to meet Best Practice Guideline targets than those without diabetes (Chi Square test, p=0.0001).
  
  
  CONCLUSIONS
  Stroke and TIA patients with diabetes may require additional resources and support in order to reach BP target values.
authors.affiliation: Hamilton Health Sciences-General Site, Stroke Prevention Clinic, Level 1, East Wing, 237 Barton Street East, Hamilton, ON L8L 2X2.
authors.forename: Gail
authors.initials: G
authors.lastname: Mackenzie
authors.forename: Sandra
authors.initials: S
authors.lastname: Ireland
authors.forename: Stacey
authors.initials: S
authors.lastname: Moore
authors.forename: Irene
authors.initials: I
authors.lastname: Heinz
authors.forename: Rosemary
authors.initials: R
authors.lastname: Johnson
authors.forename: W
authors.initials: W
authors.lastname: Oczkowski
authors.forename: D
authors.initials: D
authors.lastname: Sahlas
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D019090:Case Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000451:nursing*; D002546:Ischemic Attack, Transient / Q000451:nursing*; D008297:Male; D020377:Self Efficacy; D020521:Stroke / Q000451:nursing*
chemical_list: D000959:Antihypertensive Agents