Evaluating a Telemedicine-Supported Integrated Care Model Led by Rural Doctors to Reduce Cardiovascular and Cerebrovascular Events in Older Adults at High Stroke Risk in China

What This Trial Is About

Researchers are evaluating a new telemedicine-enabled integrated care model led by rural doctors to reduce cardiovascular and cerebrovascular events in elderly adults aged 65 years and older who are at high risk of stroke in rural China. This cluster randomized controlled trial compares this innovative care approach with enhanced usual care to address the high stroke burden in rural areas. The study aims to improve clinical outcomes by bridging gaps in rural stroke management over a 36-month period. Participants in the intervention group will receive care supported by a digital health platform that provides clinical decision support, remote specialist consultations, personalized medication adjustments, monthly monitoring, and structured patient education delivered by rural doctors. The control group will receive enhanced usual care that includes standardized training for rural doctors but without the digital platform. The study will enroll 2510 participants across 39 village clinics randomized to either group and will follow them for 36 months. During the study, participants will have regular monitoring and follow-up with rural doctors who utilize the digital platform or provide enhanced usual care. Researchers will assess outcomes including a composite measure of cardiovascular death, stroke, and hospitalization for heart failure or acute coronary syndrome at 36 months. Additional measures include recurrent stroke rates, mortality, bleeding events, risk score changes, medication adherence, and risk factor control. The study includes comprehensive follow-up and data collection to evaluate the interventions impact on participants health over three years.

A Novel Rural Integrated Care and Early Prevention Model for Older Adults at High Risk of or Living With Stroke in China