{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:40Z","timestamp":1787027320695,"version":"build-2736575974"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertension is a major risk factor for stroke recurrence in stroke patients. Home blood pressure monitoring, facilitated by digital health technologies and led by nurses, may improve blood pressure control in this high-risk population. However, the evidence is not yet conclusive. This study protocol outlines a pooled analysis of the current literatures to evaluate the effectiveness of nurse-led digital health programs for home blood pressure monitoring in stroke patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will conduct a comprehensive search of some major electronic databases (e.g., PubMed, EMBASE, Cochrane Library, and CINAHL) and trial registries for randomized controlled trials evaluating nurse-led digital health programs for home blood pressure monitoring in stroke patients. Two reviewers will independently screen titles and abstracts, review full-text articles, extract data, and assess risk of bias using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0). The primary outcome measures will be changes in both systolic and diastolic blood pressure from baseline to the end of the intervention period. Secondary outcomes include adherence to the program, patient satisfaction, and stroke recurrence. Data will be pooled and analyzed using meta-analysis techniques, if appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study will provide comprehensive evidence on the effectiveness of nurse-led digital health programs for home blood pressure monitoring in stroke patients. The findings could have substantial implications for clinical practice and health policy, potentially informing the development of guidelines and policies related to hypertension management and stroke prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>By pooling the results of randomized controlled trials, this study will offer a robust evidence base to inform clinical practice and health policy in the context of stroke patients. Despite potential limitations such as heterogeneity among studies and risk of publication bias, the rigorous methodology and comprehensive approach to data synthesis will ensure the reliability and validity of the findings. The results will be disseminated through a peer-reviewed publication and potentially at relevant conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration DOI<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/doi.org\/10.17605\/OSF.IO\/59XQA<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2024.1378144","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:50:32Z","timestamp":1721609432000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Nurse-led digital health program for home blood pressure monitoring in stroke patients: protocol for a pooled analysis of randomized controlled trials"],"prefix":"10.3389","volume":"12","author":[{"given":"Wei","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zubing","family":"Mei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaibang","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e279","DOI":"10.1212\/WNL.0000000000013115","article-title":"Global, regional, and national burden of ischemic stroke, 1990\u20132019","volume":"98","author":"Ding","year":"2022","journal-title":"Neurology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990\u20132019: a systematic analysis for the global burden of disease study 2019","volume":"20","author":"Feigin","year":"2021","journal-title":"Lancet Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/S1474-4422(19)30030-4","article-title":"The global burden of stroke: persistent and disabling","volume":"18","author":"Gorelick","year":"2019","journal-title":"Lancet Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2529","DOI":"10.1016\/j.jacc.2019.10.009","article-title":"The global burden of cardiovascular diseases and risk factors: 2020 and beyond","volume":"74","author":"Mensah","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1161\/HYPERTENSIONAHA.118.12415","article-title":"Cost-effectiveness of telemonitoring and self-monitoring of blood pressure for antihypertensive titration in primary care (TASMINH4)","volume":"73","author":"Monahan","year":"2019","journal-title":"Hypertension"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1093\/ajh\/hpz182","article-title":"Self-monitoring of blood pressure in patients with hypertension-related multi-morbidity: systematic review and individual patient data meta-analysis","volume":"33","author":"Sheppard","year":"2019","journal-title":"Am J Hypertens"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e016174","DOI":"10.1161\/JAHA.120.016174","article-title":"Impact of self-monitoring of blood pressure on processes of hypertension care and long-term blood pressure control","volume":"9","author":"Bryant","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1136\/bmj.m4858","article-title":"Home and online management and evaluation of blood pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial","volume":"372","author":"McManus","year":"2021","journal-title":"BMJ"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e831","DOI":"10.3399\/bjgp16X687037","article-title":"Self-monitoring blood pressure in patients with hypertension: an internet-based survey of UK GPs","volume":"66","author":"Fletcher","year":"2016","journal-title":"Br J Gen Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1093\/jamia\/ocaa067","article-title":"Telehealth transformation: COVID-19 and the rise of virtual care","volume":"27","author":"Wosik","year":"2020","journal-title":"J Am Med Inform Assoc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1177\/17474930211062480","article-title":"Telehealth for rehabilitation and recovery after stroke: state of the evidence and future directions","volume":"17","author":"English","year":"2022","journal-title":"Int J Stroke"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1097\/HJH.0b013e32835ca8dd","article-title":"Clinical usefulness and cost effectiveness of home blood pressure telemonitoring: meta-analysis of randomized controlled studies","volume":"31","author":"Omboni","year":"2013","journal-title":"J Hypertens"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"792","DOI":"10.58860\/ijsh.v2i10.112","article-title":"The role of telemedicine technology in stroke patient care","volume":"2","author":"Hartanto","year":"2023","journal-title":"Int J Soc Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1055\/s-0043-1772679","article-title":"Improving patient-reported outcomes in stroke care using remote blood pressure monitoring and telehealth","volume":"14","author":"Naqvi","year":"2023","journal-title":"Appl Clin Inform"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e35899","DOI":"10.1097\/MD.0000000000035899","article-title":"Revolutionizing stroke care in Africa: a mini review of the transformative potential of mobile stroke units","volume":"102","author":"Olatunji","year":"2023","journal-title":"Medicine"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1177\/1357633X211047744","article-title":"Telemedicine-enabled ambulances and mobile stroke units for prehospital stroke management","volume":"28","author":"English","year":"2022","journal-title":"J Telemed Telecare"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.aogh.2016.02.003","article-title":"Expanding the role of nurses to improve hypertension care and control globally","volume":"82","author":"Himmelfarb","year":"2016","journal-title":"Ann Glob Health"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.ijnurstu.2017.10.006","article-title":"Development and evaluation of a nurse-led hypertension management model: a randomized controlled trial","volume":"77","author":"Zhu","year":"2018","journal-title":"Int J Nurs Stud"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"c3995","DOI":"10.1136\/bmj.c3995","article-title":"Nurse led interventions to improve control of blood pressure in people with hypertension: systematic review and meta-analysis","volume":"341","author":"Clark","year":"2010","journal-title":"BMJ"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1007\/s00520-007-0377-x","article-title":"Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment: an international survey","volume":"16","author":"Kav","year":"2008","journal-title":"Support Care Cancer"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1093\/ageing\/afx076","article-title":"Nurse interventions to improve medication adherence among discharged older adults: a systematic review","volume":"46","author":"Verloo","year":"2017","journal-title":"Age Ageing"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1093\/eurjcn\/zvad040","article-title":"Effectiveness of nurse-led interventions versus usual care to manage hypertension and lifestyle behaviour: a systematic review and meta-analysis","volume":"23","author":"Bulto","year":"2023","journal-title":"Eur J Cardiovasc Nurs"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12912-022-01170-z","article-title":"Nurse-led telehealth intervention effectiveness on reducing hypertension: a systematic review","volume":"22","author":"Kappes","year":"2023","journal-title":"BMC Nurs"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005182.pub4","article-title":"Interventions used to improve control of blood pressure in patients with hypertension","author":"Glynn","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1161\/HYPERTENSIONAHA.119.13273","article-title":"Interactive mobile health intervention and blood pressure management in adults: a meta-analysis of randomized controlled trials","volume":"74","author":"Lu","year":"2019","journal-title":"Hypertension"},{"key":"ref26","author":"Higgins","year":"2021"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1136\/bmj.g7647","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation","volume":"349","author":"Shamseer","year":"2015","journal-title":"BMJ"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1016\/S0140-6736(18)30309-X","article-title":"Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial","volume":"391","author":"McManus","year":"2018","journal-title":"Lancet"},{"key":"ref29","volume-title":"The patient satisfaction questionnaire short-form (PSQ-18)","author":"Marshall","year":"1994"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref31","first-page":"15","volume-title":"Handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach. Updated October","author":"Sch\u00fcnemann","year":"2013"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"ref35","first-page":"89","article-title":"A nonparametric \u201ctrim and fill\u201d method of accounting for publication bias in meta-analysis","volume":"95","author":"Duval","year":"2000","journal-title":"J Am Stat Assoc"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1161\/HYPERTENSIONAHA.120.15873","article-title":"Evidence and recommendations on the use of telemedicine for the management of arterial hypertension: an international expert position paper","volume":"76","author":"Omboni","year":"2020","journal-title":"Hypertension"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"102432","DOI":"10.1016\/j.eclinm.2024.102432","article-title":"Effectiveness of digital health interventions on blood pressure control, lifestyle behaviours and adherence to medication in patients with hypertension in low-income and middle-income countries: a systematic review and meta-analysis of randomised controlled trials","volume":"69","author":"Boima","year":"2024","journal-title":"EClinicalMedicine"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"13","DOI":"10.21037\/mhealth-23-66","article-title":"Home blood pressure measurement self-reporting in real-life practices using the Hy-result app: self-monitoring and digital pathway","volume":"10","author":"Postel-Vinay","year":"2024","journal-title":"Mhealth"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1097\/CIN.0000000000001050","article-title":"Development and evaluation of a Mobile application to prevent recurrent stroke by enhancing self-management on health outcomes for stroke survivors","volume":"42","author":"Jeong","year":"2024","journal-title":"Comput Inform Nurs"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"e031307","DOI":"10.1161\/JAHA.123.031307","article-title":"Achieving blood pressure goals and addressing inequities in blood pressure management after stroke","volume":"13","author":"Bushnell","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1001\/jama.2013.6549","article-title":"Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: a cluster randomized clinical trial","volume":"310","author":"Margolis","year":"2013","journal-title":"JAMA"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"J Am Coll Cardiol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1378144\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:50:36Z","timestamp":1721609436000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1378144\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,22]]},"references-count":42,"alternative-id":["10.3389\/fpubh.2024.1378144"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2024.1378144","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,22]]},"article-number":"1378144"}}