{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:56:21Z","timestamp":1789232181139,"version":"build-2803163510"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>Disease management is a healthcare strategy that includes self-management education and treatment coordination. We conducted a randomized controlled trial to determine whether a disease management program intervention could improve risk factor profiles and, thus, reduce the recurrence of stroke and other cardiovascular diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>This study is a prospective randomized, open-label, parallel group study involving outpatients with a history of stroke. Between September 2010 and November 2012, we enrolled patients aged between 40 and 80 years who experienced their last ischemic stroke event or transient ischemic attack within 1 year. After stratifying by the ischemic stroke subtype, 321 subjects (67.5\u00b18.5 years, 95 female) were randomly assigned to either the disease management program intervention group (n=156) or the usual care group (n=165). The primary end point of this study was the difference in the Framingham risk score (general cardiovascular disease 10-year risk) from baseline. The secondary end points of this study included stroke recurrence, onset of cardiovascular disease, all-cause mortality, and all vascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>Regarding the primary end point, there was no significant difference in the changes in the Framingham risk score at any follow-up time between the groups. The incidence of stroke recurrence tended to be lower in the disease management program intervention group, although no significant difference was found (hazard ratio, 0.49; 95% CI, 0.19\u20131.29).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>We were unable to demonstrate a clear benefit of disease management program intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT02121327.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.118.020888","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T05:01:07Z","timestamp":1550552467000},"page":"705-712","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Effects of a Disease Management Program for Preventing Recurrent Ischemic Stroke"],"prefix":"10.1161","volume":"50","author":[{"given":"Yasuko","family":"Fukuoka","sequence":"first","affiliation":[{"name":"From the Department of Nursing Science (Y.F., M. Moriyama), Hiroshima University Graduate School of Biomedical and Health Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohisa","family":"Hosomi","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience and Therapeutics (N.H., M. Matsumoto), Hiroshima University Graduate School of Biomedical and Health Sciences, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Hyakuta","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Japanese Red Cross Hiroshima College of Nursing (T.H.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyonori","family":"Omori","sequence":"additional","affiliation":[{"name":"Nagoya City University, Graduate School of Medical Sciences, Japan (T.O.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Neurology, TOYOTA Memorial Hospital, Japan (Y.I.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyunichi","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Stroke Medicine, Kawasaki Medical School Hospital, Japan (J.U., Y.Y.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Yagita","sequence":"additional","affiliation":[{"name":"Department of Stroke Medicine, Kawasaki Medical School Hospital, Japan (J.U., Y.Y.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Neurological Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan (K.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayasu","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience and Therapeutics (N.H., M. 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