Feasibility and acceptability study of risk reduction approach for stroke prevention in primary care in Western India.

Abstract

Stroke is among the leading cause of morbidity and mortality and prevention is the need of the hour. Risk assessment of stroke could be done at primary care. A study was hence planned to assess if an information, education, and communication (IEC) intervention module could be used to address risk factors of stroke among attendees of primary care in Western India. Patients (>30 years) attending primary care center were enrolled (n = 215). Knowledge, attitude, and practice (KAP) questionnaire was administered at baseline and end line, and detailed diagnosis (hypertension and/diabetes, stroke, coronary artery disease, etc.) was noted from written records. A predesigned IEC module was administered about stroke, risk factors, and their prevention. Body mass index (BMI) and waist-to-hip ratio were taken before and after 16 weeks. A total of 215 participants (M: F = 85:130; mean age = 51.66 ± 13.32 years) had risk factors such as hypertension (26.7%), diabetes (32.5%), history of stroke (n = 3; = 1.39%), and 7.4% (16/215) had coronary artery disease. Before and after comparison of KAP scores indicated significant difference (62.23 ± 19.73 vs. 75.32 ± 13.03); P ≤ 0.0001). Change of waist-to-hip ratio occurred from baseline 0.91-0.9 (P ≤ 0.001). Comparison of the proportion of patients taking antihypertensives before and after IEC intervention was statistically significant (P < 0.05), indicating improvement in drug compliance. BMI comparison changed marginally (26.5 ± 4.7 vs. 26.2 ± 4.5) before and after but was not significant (P ≥ 0.05). The intervention was found to be feasible and acceptable. IEC intervention appears to be a low-cost, feasible, and acceptable implementation model for addressing risk factors for stroke in primary care.