title: Baseline feature of a randomized trial assessing the effects of disease management programs for the prevention of recurrent ischemic stroke.
abstract: Comprehensive and long-term patient education programs designed to improve self-management can help patients better manage their medical condition. Using disease management programs (DMPs) that were created for each of the risk factor according to clinical practice guidelines, we evaluate their influence on the prevention of stroke recurrence.
  
  
  
  This is a randomized study conducted with ischemic stroke patients within 1 year from their onset. Subjects in the intervention group received a 6-month DMPs that included self-management education provided by a nurse along with support in collaboration with the primary care physician. Those in the usual care group received ordinary outpatient care. The primary end point is a difference of the Framingham risk score-general cardiovascular disease 10-year risk [corrected]. Patients were enrolled for 2 years with plans for a 2-year follow-up after the 6-month education period (total of 30 months).
  
  
  
  A total of 321 eligible subjects (average age, 67.3 years; females, 96 [29.9%]), including 21 subjects (6.5%) with transient ischemic attack, were enrolled in this study. Regarding risk factors for stroke, 260 subjects (81.0%) had hypertension, 249 subjects (77.6%) had dyslipidemia, 102 subjects (31.8%) had diabetes mellitus, 47 subjects (14.6%) had atrial fibrillation, and 98 subjects (30.5%) had chronic kidney disease. There were no significant differences between the 2 groups with respect to subject characteristics.
  
  
  
  This article describes the rationale, design, and baseline features of a randomized controlled trial that aimed to assess the effects of DMPs for the secondary prevention of stroke. Subject follow-up is in progress and will end in 2015.
authors.affiliation: Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: yasukofukuoka@hotmail.com.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Fukuoka
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Naohisa
authors.initials: N
authors.lastname: Hosomi
authors.affiliation: Faculty of Nursing, Japanese Red Cross Hiroshima College of Nursing, Hiroshima, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hyakuta
authors.affiliation: National Institute of Health and Nutrition, Tokyo, Japan.
authors.forename: Toyonori
authors.initials: T
authors.lastname: Omori
authors.affiliation: Department of Neurology, TOYOTA Memorial Hospital, Toyota, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School Hospital, Kurashiki, Japan.
authors.forename: Jyunichi
authors.initials: J
authors.lastname: Uemura
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School Hospital, Kurashiki, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Division of Nursing Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Moriyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000401:mortality / Q000451:nursing / Q000628:therapy*; D015897:Comorbidity; D003299:Cooperative Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033183:Interdisciplinary Communication; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010353:Patient Education as Topic; D058007:Physicians, Primary Care; D016016:Proportional Hazards Models; D012008:Recurrence; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D012648:Self Care; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000451:nursing / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Stroke; disease management programs; prevention of recurrence; primary care setting; risk factor control; self-management