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2 Ways Remote Patient Monitoring Prevent Occurrence of Stroke

Remote patient monitoring has features which are appropriate for stroke prevention and management strategies. When compared to traditional outpatient management, the advantages of remote patient monitoring include continuous availability and real-time monitoring at a cheaper cost.

Stroke is a prominent cause of death and disability. The progress in avoiding stroke deaths has paused after decades of reduction. Every year, about 800,000 individuals suffer a stroke, more than 140,000 people die, and many survivors are left disabled. This is concerning because around 80% of strokes can be avoided. Other facts about stroke include the following:

  • Stroke was responsible for one out of every six deaths caused by cardiovascular disease in 2018.[1]
  • Every 40 seconds, someone in the United States gets a stroke. A stroke kills someone every 4 minutes.[1]
  • A stroke affects more than 795,000 people in the United States each year.[1]
  • There are around 610,000 first or new strokes.[1]
  • People who have suffered a previous stroke account for almost one-fourth of all strokes.[1]
  • Ischemic strokes, in which blood flow to the brain is stopped, account for about 87 percent of all strokes.[1]
  • Between 2014 and 2015, stroke-related costs in the United States were almost $46 billion.[1]

Advances in remote patient monitoring have allowed management of conditions that were previously only available in health centers. A multimodal remote patient monitoring platform would increase stroke awareness and improve the quality of life of stroke patients, as well as promote risk factor control. The goal of remote patient monitoring in patients that have already suffered a stroke is to manage post-hospital stroke patients who are also receiving clinical care and promote adherence to stroke management by providing less difficulty and satisfaction with the system in patients at risk for stroke and after intervention in stroke patients. Remote patient monitoring can also help stroke patients keep their blood pressure under control and keep an eye on other physical metrics. This can be done quickly and at a lower cost.

Remote Patient Monitoring in Patients at Risk for Stroke

Despite the fact that strokes are a leading cause of death and disability, stroke risk can be considerably decreased by raising awareness, controlling existing medical conditions, and leading a healthy lifestyle. Taking preventative measures is simple. Developing and maintaining healthy behaviors can help avoid strokes and a variety of other diseases. High blood pressure, smoking, diabetes, high blood cholesterol levels, heavy alcoholic drinking, a high salt and high fat diet, and a lack of exercise are all lifestyle factors that raise the risk of stroke.

Physical activity increases (by 800-1104 steps/day) with remote patient monitoring according to prior smartphone usage studies.[5] Step count, walking distance, calories spent, exercise time, and heart rate during exercise are all included in the smart band’s exercise program module. These numbers are kept track of and examined afterwards. The intensity of walking, which is measured by the heart rate increase and walking speed, determines the effectiveness of the workout. The applications of some remote monitoring devices also have monthly updated information on muscular exercises and stretching techniques. Users are given daily exercise activities, and their progress toward their fitness goals is tracked.

Randomized controlled trials have been done to see if remote patient monitoring can help people keep their blood pressure under control to prevent heart disease.[6] In individuals with uncontrolled hypertension, self-measurement of blood pressure with remote patient monitoring has been proven to enhance blood pressure control. When compared to a control group that received only medical treatment, studies using remote patient monitoring for glucose control reported a more than 1% greater decrease in hemoglobin A1c in an intervention group that received summarization of glycemic control, diabetes medication management, and information on lifestyle behaviors with current treatment. The integrated exercise program, blood pressure management, and glucose management functions of some remote patient monitoring devices may all help with effective health behavior modifications, blood pressure management, and glucose management that can reduce the occurrence of stroke.

Management of stroke with early arrival at the hospital is a critical element in enhancing the efficacy of intravenous thrombolysis administered within 3 hours in elderly patients over the age of 80 and 4.5 hours in individuals aged 18 to 80 years.[3] Better stroke outcomes are linked to proper stroke awareness, which includes understanding of stroke symptoms, suitable remedial activities, and time-sensitive treatment. With daily stroke-related articles and videos, exercise routines for stroke prevention, and commonly asked questions and answers for strokes, remote patient monitoring provides for greater stroke awareness. Patients would be able to differentiate true stroke symptoms if they had a high level of stroke awareness, which would aid them in seeking treatment sooner.

Remote Patient Monitoring in Recurrent Strokes

When compared to first-ever stroke, recurrent stroke accounts for roughly 30% of all stroke episodes and causes higher death, disability, and economic burden.[2] In stroke survivors, the cumulative risk of recurrence is 11.1 percent after one year and 26.4 percent after five years.[2] Because recurrent stroke is strongly linked to the presence of vascular risk factors, current stroke preventive efforts have centered on establishing interdisciplinary strategies to treat hypertension, diabetes, dyslipidemia, obesity, and physical inactivity. To minimize modifiable risk factors and maintain secondary prevention on a regular and extended basis, stroke patients require simple, accessible, reciprocal, and low-cost supportive measures.

Patients with chronic conditions like stroke have been shown to benefit from emerging remote patient monitoring that aid in blood pressure control and medication adherence. Because blood pressure control is a critical component of secondary stroke prevention, emerging remote patient monitoring could be used to effectively maintain blood pressure with daily blood pressure monitoring, exercise, and medication tracking. Secondary prevention for stroke survivors requires adherence to numerous treatment regimens, including antiplatelet, antihypertensive, antidiabetic, and lipid-lowering drugs, and emerging remote patient monitoring could be used to track and encourage patients’ medication intake. In a prior study, adherence to antihypertensive medicine was found to be dose-dependently linked to a lower risk of stroke, while persistence with antiplatelet therapy was linked to a 72.5 percent lower risk of recurrent ischemic stroke.[4] As a result, remote patient monitoring for post-stroke must include medication management to track and encourage the use of medications such as antiplatelet and antihypertensive therapies. Drug alerts, prescription information, and registration of consumption and medication adverse effects, if any, are all included in the app’s medication management.

Remote patient monitoring improves awareness of strokes, depression, and blood pressure. Because of their wide availability, near-real-time responsiveness, and low cost, new remote patient monitoring tools could be new nonpharmacological secondary prevention measures.

Takeaway

Stroke risk can be reduced by taking steps to control certain conditions, and remote patient monitoring serves a vital role in the primary and secondary prevention of stroke. Remote patient monitoring raises awareness of stroke that could result in a substantial shift in hospitalization for stroke care planning. Multifaceted remote patient monitoring with responsive capabilities could make home care more affordable, quick, and efficient, which could help prevent both primary and secondary strokes.

A remote patient monitoring platform for stroke patients has been proven to have several potential benefits for various outcomes of stroke prevention, such as blood pressure and medication adherence. This suggests that a remote patient monitoring platform might be used to target a wider range of outcomes, such as depression and quality of life in patients with strokes.

References:

  1. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2020 update: a report from the American Heart Associationexternal icon. Circulation. 2020;141(9):e139–e596.
  2. Hankey GJ. Long-term outcome after ischaemic stroke/transient ischaemic attack. Cerebrovasc Dis 2003;16 Suppl 1:14-19.
  3. National Institute of Neurological DisordersStroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995 Dec 14;333(24):1581-1587.
  4. Burke JP, Sander S, Shah H, Zarotsky V, Henk H. Impact of persistence with antiplatelet therapy on recurrent ischemic stroke and predictors of nonpersistence among ischemic stroke survivors. Curr Med Res Opin 2010 May;26(5):1023-1030.
  5. Bort-Roig J, Gilson ND, Puig-Ribera A, Contreras RS, Trost SG. Measuring and influencing physical activity with smartphone technology: a systematic review. Sports Med 2014 May;44(5):671-686.
  6. Liu S, Dunford SD, Leung YW, Brooks D, Thomas SG, Eysenbach G, et al. Reducing blood pressure with Internet-based interventions: a meta-analysis. Can J Cardiol 2013 May;29(5):613-621.

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