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RECRUITING

NCT06657235

Transitional Care Program to Improve Risk Factors in Stroke Survivors

Sponsor: Syntrillo, Inc

View on ClinicalTrials.gov

Summary

The goal of this clinical trial is to evaluate whether our transitional care program helps stroke survivors better manage their risk factors for stroke to lower the risk of a repeat stroke. The main question it aims to answer is: \- Does the program help participants meet the targets set by the American Heart Association clinical guidelines for control of risk factors associated with stroke? Researchers will compare participants enrolled right after being discharged from the hospital to participants enrolled around 3-5 months after being discharged to examine whether timing differences in enrollment affect the efficacy of the program. Participants will: * Keep track of their medications, their exercise, and their health information using smart devices provided by the study * Answer questions about their health and lifestyle * Meet with our team of healthcare providers

Official title: Improved Risk Factor Control Through a Transitional Care Program for Stroke Survivors

Key Details

Gender

All

Age Range

30 Years - Any

Study Type

INTERVENTIONAL

Enrollment

224

Start Date

2024-08-16

Completion Date

2025-12

Last Updated

2025-06-03

Healthy Volunteers

Conditions

Stroke, Ischemic

Interventions

OTHER

Transitional Care Program

Participants will receive personalized risk-factor management stroke care from a multidisciplinary team trained by our neurologists to understand the needs of stroke survivors and the nuances of stroke care. Risk factor data from in-home devices, health records, and self-reports will be collected along with functional status and behavioral data obtained through validated questionnaires and an occupational therapy evaluation. Syntrillo's neurology provider will review this data, assess the participant through a telemedicine encounter, and create a comprehensive secondary prevention plan to supplement the participant's care plan at discharge. Data generated through these clinical encounters will be de-identified and used for subsequent development of Syntrillo's stroke management technology.

Inclusion Criteria: All Cohorts: * Age 30 or above * Evidence of ischemic stroke documented on CT or MRI * Modified Rankin score of 3 or less Early Enrollment: * Admission for ischemic stroke at a participating site * Enrolled during their admission for ischemic stroke or within 24 hours of discharge Late Enrollment: * Stroke survivors previously admitted at the participating sites' inpatient stroke unit * Enrollment date between 1 and 6 months after discharge for inpatient admission for ischemic stroke Exclusion Criteria: * Participants determined to have hemorrhagic or periprocedural stroke based on hospital EMR review will be excluded. * Participants determined to have an ischemic stroke due to dissection based on hospital EMR review will be excluded. * Participants who lack capacity determined by the care team during their hospitalization (for the early enrollment group) or their most recent clinical encounter (for the late enrollment group) will be excluded. * Participants with a diagnosis of dementia will be excluded. * Participants with acute subdural hemorrhage will be excluded. * Participants with hemorrhagic stroke due to vascular abnormality (aneurysm or AVM) or trauma will be excluded. * Participants who cannot perform the following will be excluded: 1. offer a consistent choice about participating in the study 2. demonstrate that they can comprehend and recall major features of the study including: participation is voluntary, the major procedures, the primary risk, and the primary benefit. * Participants who are discharged to Long-term Acute Care Hospitals will be excluded. * Participants who are unable to read or communicate fluently in English will be excluded. * Participants who do not have reliable internet access to complete telemedicine visits per self-report will be excluded. * Participants already enrolled in another clinical study which could impact the frequency of monitoring or care that participant receives. * Participants who do not reside in Virginia, West Virginia, Tennessee, Oklahoma, Illinois, or Michigan will be excluded.

Locations (1)

Valley Health System

Winchester, Virginia, United States