Stroke coach: a pilot study of a personal digital coaching program for patients after ischemic stroke
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Despite recent advances in acute stroke care, the risk of recurrent stroke remains high. On behalf of the Belgian Stroke Council (BSC), a nurse-led self-management program was developed, using a personal coach and digital platform with the aim of improving cardiovascular risk factor control in patients after ischemic stroke. The program was implemented in four Belgian hospitals. The stroke coach provided one educational session during hospitalization. After discharge, the patient received tips and tricks concerning a healthy lifestyle through the customized platform. The stroke coach set up video appointments through the platform at regular intervals. Primary endpoint of our study was the change in SCORE (Systematic COronary Risk Evaluation: High and Low cardiovascular Risk Charts) risk at baseline and 6 months compared with a historical control group who received standard care. A total of 147 patients were included for a follow-up period of 6 months. The mean SCORE in the intervention group showed a statistically significant reduction of 3.2 (p < 0.001) at 6 months. However, comparison between control and intervention groups was non-significant (p = 0.55). Secondary endpoints are promising with a medication adherence of 96%. Reported quality of life also improved (p < 0.001). No significant improvement in the modified Rankin scale (mRS) was observed (p = 0.720). Five percent of patients suffered a recurrent stroke. Our project consisting of a coached lifestyle intervention and digital platform shows promise in improving stroke recurrence rates, therapeutic adherence and quality of life in a Belgian healthcare setting.
KeywordsSecondary prevention Telemedicine Personal coach Digital platform
We thank the stroke coaches, Delphine Mahieu, Delphine Standaert, Julie Derous and Anja Lorrez for their hard work and dedication to the project. We thank Trendhuis and Zebra Academy for the help and technical support with the platform and VOKA, Wit-Gele Kruis West-Vlaanderen, Lokaal Multidisciplinair Netwerk Brugge-Houtland-Oostende and Bluehealth Innovation Center (MIC) for their input and financial aid. This project was supported by a project funding (mHealth) of the Belgian National Institute for Health and Disability Insurance and the Belgian Stroke Council.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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