None listed
Conditions
Brief summary
The National Health and Morbidity Survey (NHMS) in 2011, estimated prevalence of stroke was 0.3% among Malaysians. However, stroke patients who are Asians such as Malaysians, were reported to be generally younger whereby stroke onset for Malaysians were with the mean age of 41.5±8.8 years. Up to 35% of all people who experience a transient ischemic attack (TIA, or mini-stroke) will proceed to another stroke within weeks or months. In Malaysia, an estimated of 40,000 acute stroke cases are recorded yearly and a history of stroke or TIA hospitalization contributed 23% of the risk factors to a recurrent stroke. A recent study reported that 38% of non-adherence to prescribed medications contributed to the prevalence of stroke in Malaysia. There were some effort done by Malaysian government to encourage community responsiveness to detect stroke symptoms and enhance awareness to a stroke patient’s need such as FAST acronym and website of stroke information based on Malaysian perspectives. However there is still a need to control stroke risk factors to reduce stroke burden in Malaysia. A summary of a few studies suggested that illness perceptions, knowledge and awareness, treatment beliefs, attitude are linked to self-efficacy which is a predictor to medication taking behavior such as understanding and using medication. In addition, a personalized treatment warrants a better disease management outcome which involve active communication and behavioral changes additional to counseling session were found to be more promising compared to the conventional practice with only patient education and counseling. However, these studies have shown mixed significant results which involved various style of delivery and facilities which varied across culture, setting, sample and study outcomes. Hence, this is the first study in Malaysia which would be observing the possibilities of patient care led by interactive videos emphasizing on personalized learning and guided by healthcare providers. The alternate hypothesis: There is a significant improvement of medication understanding and use self-efficacy observed in the intervention group who was given a personalized video intervention. The null hypothesis: There is no significant improvement of medication understanding and use self-efficacy observed in the intervention group who was given a personalized intervention.
Interventions
This is a randomized controlled trial between 2 groups ( 1 control arm and 1 intervention arms) which would like to evaluate the effectiveness of narrative videos about patient and doctor stories influencing medication understanding and use self-efficacy among stroke patients. The informed and consented patients would be selected according to inclusion and exclusion criteria and follow randomization process.
The control arm receives the usual care treatment by the hospital healthcare providers a
This is a randomized controlled trial between 2 groups ( 1 control arm and 1 intervention arms) which would like to evaluate the effectiveness of narrative videos about patient and doctor stories influencing medication understanding and use self-efficacy among stroke patients. The informed and consented patients would be selected according to inclusion and exclusion criteria and follow randomization process. The control arm receives the usual care treatment by the hospital healthcare providers and written information about recurrent stroke, and it's medication management whereas the intervention arm receives standard care treatment, written information about recurrent stroke and its management and a video narrative from a neurologist and patient story in Malay or English. The video from a neurologist provides his point of view regarding stroke patients. Whereas the videos of a stroke patient depict his illness story and how he overcomes his challenges. Further queries regarding their medication or treatment would be documented and would be politely informed to refer to their physicians and hospital management to maintain internal validity. This intervention aims to enhance self-efficacy via health belief constructs and self-empowerment characteristics to control stroke risk factors leading to recurrent stroke. The videos would be shown personally using a tablet or mobile device by the researcher himself at baseline, 1st, 3rd and 6th month of study during clinic hours only. Whereby outcome measures are done 1st, 3rd, 6th and 12th month. A 6 month non intervention as retention period would be applied to evaluate sustainability of intervention. The videos would not be shared online to maintain external validity.
Sponsors
School of Medicine and Health Sciences, Monash University, Malaysia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria 1) Patient with definitive diagnosis of stroke (MRI/MRA,CT, CT angiography- confirmed diagnosis by neurologist). 2) Patient aged 18 years and above 3.Patient on antithrombotics and any stroke preventative medications (e.g. statins, hyperglycaemic agents, antihypertensive agents. 4) Patients who are able to converse, read and write in Malay or English.
Exclusion criteria
Exclusion criteria 1) Patient with stroke due to accident, external or unexplained causes. 2) Patient with cognitive impairment and/or disorientation (MMSE score < 24) 3) Patient who depends help from caregivers to take their medications. 4) Patient with anxiety and/or depression (PHQ-9 score > 4)
Outcome results
None listed