A Cluster Randomized Trial of a Telemedicine-Enabled Integrated Care Model for Stroke Prevention and Management in Rural Elderly Adults in China
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Enhanced Usual Stroke Care, Digital Health Platform-Supported Integrated Stroke Management.
- Who it may be relevant to
- Registry conditions: Stroke, Brain Ischemia, Cerebral Hemorrhage, Transient Ischemic Attack. Basic parameters: from 65 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- China
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
A Prospective, Open-Label, Cluster Randomized Controlled Trial to Evaluate the Efficacy of a Rural Doctor-Led, Telemedicine-Supported Integrated Care Model for Reducing Cardiovascular and Cerebrovascular Events in Elderly Adults at High Risk of Stroke in China
Overview
This cluster randomized controlled trial aims to evaluate the effectiveness of a novel telemedicine-enabled integrated care model led by rural doctors in reducing cardiovascular and cerebrovascular events among elderly adults (≥65 years) at high risk of stroke in rural China. A total of 39 village clinics will be randomized to either the intervention group (digital health platform-supported integrated care) or the control group (enhanced usual care). The primary outcome is a composite of cardiovascular death, stroke, and hospitalization for heart failure or acute coronary syndrome at 36 months.
Detailed description
Stroke is the leading cause of death and disability in China, with a disproportionately higher burden in rural areas. This study proposes a "technology-enabled, vertically integrated, pathway-integrated, performance-incentivized" care model to address the gaps in rural stroke management. The intervention group will use a dedicated digital health platform (https://ricestroke.sqfh.org.cn:8421/gp/#/login) that provides clinical decision support, remote consultation with specialists, patient follow-up reminders, and performance feedback for rural doctors. The control group will receive enhanced usual care without the digital platform. The study will enroll 2510 participants and follow them for 36 months to assess the impact of the intervention on clinical outcomes, risk factor control, and medication adherence.
Interventions
- Behavioral Enhanced Usual Stroke Care
Rural doctors provide monthly face-to-face care based on national guidelines, including symptom monitoring, blood pressure measurement, medication guidance, and patient education. Referrals to tertiary hospitals are made through conventional channels. - Behavioral Digital Health Platform-Supported Integrated Stroke Management
Patient electronic health record management AI-powered clinical decision support for medication adjustment based on Chinese stroke guidelines Weekly remote video consultation with neurologists from tertiary hospitals Automated follow-up and medication adherence reminders Structured education and training for both rural doctors and patients
Primary outcome measures
- Composite of Cardiovascular Death, Stroke, and Hospitalization for Heart Failure or Acute Coronary Syndrome at 36 Months [Time frame: 36 months]
Secondary outcome measures (6)
- First Recurrent Stroke Event Rate at 36 Months [Time frame: 36 months]
- All-Cause Mortality at 36 Months [Time frame: 36 months]
- Cardiovascular-Specific Mortality at 36 Months [Time frame: 36 months]
- Hospitalization for Heart Failure or Acute Coronary Syndrome at 36 Months [Time frame: 36 months]
- Major Bleeding Events (ISTH Criteria) at 36 Months [Time frame: 36 months]
- Change in CHINA-PAR Score from Baseline to Month 12 [Time frame: Baseline, Month 12]
Eligibility criteria
Inclusion criteria
- Aged 65 years or older
- Rural residents with household registration or long-term residence (≥6 months/year) in the study area
- High risk of stroke as defined by the National Health Commission's "8+2" stroke risk screening tool: ≥3 risk factors OR history of stroke/TIA
- Willing to receive long-term health management from the assigned village clinic
- Written informed consent provided by the participant or their legal representative
Exclusion criteria
- Severe dementia or psychiatric disorder that prevents completion of study follow-up and assessments
- Life expectancy less than 1 year (e.g., advanced malignancy, end-stage renal disease)
- Currently participating in another interventional clinical trial
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Prevention
Study locations
China · 1 center
- Suqian Hospital Affiliated to Jiangsu Provincial People's Hospital — Suqian
Publications
- Hao R, Qi X, Xia X, Wang L, Li X. Malnutrition on admission increases the in-hospital mortality and length of stay in elder adults with acute ischemic stroke. J Clin Lab Anal. 2022 Jan;36(1):e24132. doi: 10.1002/jcla.24132. Epub 2021 Dec 8. PMID 34877710
Identifiers
NCT: NCT07628283 · RICE-STROKE-2026-001