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. 2018 May 7;2018(5):CD009103. doi: 10.1002/14651858.CD009103.pub3

MIST 2014.

Study characteristics
Methods RCT
Unit of randomisation: participant
Participants Place of recruitment: inpatient ward
Numbers randomised: total: 386 (I: 193; C: 193)
Completing final follow‐up: 86% for systolic BP, 61% for LDL
Inclusion criteria: first ever stroke
Exclusion criteria: impairment precluding participation (e.g. aphasia, psychiatric conditions, cognitive impairment), unable to converse in English, unable to give consent, other condition likely to affect participation (e.g. significant aphasia), receiving psychiatric/psychological treatment, discharged to hospital/nursing home where medications given by staff or if participation likely to overburden individual
Type of stroke: not stated
Mean age (SE): not stated
Gender (% men): not stated
Ethnicity (%) : Maori (I: 10.3 C: 7.2), Pacific Islander (I: 8.8 C: 4.7), Asian (I: 2.1% C: 4.7%), New Zealand European/other (I: 78.8 C: 83.4)
Socio‐economic or socio‐demographic status (%):
  • marital status: married/civil union/de facto (I: 69.9 C: 72.5), never married (I: 4.7 C: 5.2), separated/divorced/widowed (I: 25.4 C: 22.3)

  • prior living situation: living with family (I: 73.1 C 76.7), living with others (I: 3.1 C: 4.1), living alone (I: 23.8 C: 19.2)

  • prior dwelling place: own home (I: 64.2 C: 73.1), rented (I: 20.7 C: 16.1), living with family/friends (I: 5.2 C 3.1), retirement village/similar (I: 8.3 C: 5.2), rest home/private hospital (I: 0.5 C: 0.5), other (I: 1 C: 0.5), missing (I: 0 C: 0.5)

  • completed high school: yes (I: 80.3 C: 82.4), no (I: 19.2 C: 17.1), missing (I: 0.5 C: 0.5)

  • highest further qualification: degree (I: 17.6 C: 21.8), diploma/certificate (I: 17.1 C: 21.8), trade/technical (I: 16.1 C: 14), other (I:3.1 C: 6.2), missing (I: 46.1 C: 36.3)

  • employment type: professional (I: 7.8 C: 9.3), manager/technical (I: 18.1 C: 19.7), skilled non‐manual (I: 10.4 C: 4.7), skilled manual (I: 8.8 C: 8.3), partly skilled (I: 3.6 C: 3.1), unskilled (I: 5.2 C: 4.1), armed forces (I: 0.5 C: 0.5)

Interventions Intervention details: usual care, in addition to 4 motivational interviewing sessions (at 28 days, 3,6 and 9 months post stroke) ‐ the first session was face‐to‐face either in the participant's home or in hospital and then a further 3 by telephone or face‐to‐face if telephone was not possible. A letter was sent to the participant's GP to remind them of the participant's participation and a reminder of recommendations to monitor BP and lipid
Location: secondary care/community
Mode of delivery: face‐to‐face and/or telephone follow‐up
Personnel responsible for delivery: researcher
Timing post‐stroke: started at 28 days post stroke
Control: after discharge, participants were followed up by their GP or designated stroke centre every 3 to 6 months as part of the usual stroke care
Outcomes Self‐reported medication adherence at 3, 6 and 9 months; systolic BP at 12 months; LDL, HDL and total cholesterol at 12 months
General Information Funding: funded by the New Zealand Health Research Council (HRC Ref 10/458)
Country of origin: New Zealand
Publication language: English
Notes Analysis method: stated intention‐to‐treat
Risk of bias: low
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk A randomisation technique from a previously published protocol was used
Allocation concealment (selection bias) Low risk Treatment allocation was determined by randomisation and was concealed
Incomplete outcome data (attrition bias)
All outcomes Low risk Sensitivity analysis was undertaken. Missing data on the primary outcome was imputed using the value carry forward approach
Selective reporting (reporting bias) Low risk The study protocol was published within a previously peer reviewed journal
Other bias Low risk The study appears to be free of other sources of bias