Transitional Care Program to Improve Risk Factors in Stroke Survivors
Trial Parameters
Brief 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
Eligibility Criteria
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