Apps Improve Stroke Care
In the management of acute and chronic stroke, smartphone apps enhance communication between first responders and waiting hospital staff and reduce door-to-needle time, according to a literature review (Journal of Stroke. Published online Sept. 30, 2022.)
The investigators reviewed 43 studies of stroke-related mobile phone apps that were designed for the clinical management of stroke between June 1, 2007, when the first iPhone was introduced, and January 31, 2022.
The apps were classified into the following three groups, according to their purpose: primary prevention apps, acute stroke management apps, and postacute stroke apps.
Prevention and Management
The investigators found one primary prevention app, the Stroke Riskometer, that was based on an algorithm derived from the Framingham Stroke Risk Score and was designed to educate patients about diet, physical activity, and the warning signs of stroke. However, their review failed to show that the app was beneficial, compared with standard cardiovascular risk reduction.
Apps appeared to aid acute stroke management, according to the researchers.
Prehospital apps, such as iLAMA, Smartphone-Assisted Pre-Hospital Medical Information System, FAST-ED, Egyptian Stroke Network, Act Fast, and the Mayo Clinic Acute Stroke Evaluation app were found to speed up stroke recognition, activate emergency medical services for speedier transport to the hospital, and facilitate communication with in-hospital stroke teams. All these prehospital apps reduced door-to-needle time.
The JOIN app also was shown to significantly reduce door-to-needle time, compared with no app support, in several studies.
StopStroke, another app that focuses on instant communication among physicians and allows real-time sharing of clinical data of stroke patients, reduced door-to-image and door-to-needle time, compared with no app.
Postacute Stroke Apps
The Rehabilitation Guardian app, consisting of a health reminder, consultation, health information and patient diary, gives medical information and provides rehabilitation exercises. Patients can enter their clinical information, and the medical staff can access it and assist with the rehab process remotely.
As for apps for chronic management and secondary prevention, the researchers found that the PRESTRO app, which combines motivational support for a healthy lifestyle and tells patients to take their medications and measure their blood pressure, successfully got patients to be more physically active, compared with those who did not use the app.
Another app for secondary prevention, the Korea University Health Monitoring System for Stroke (KUHMS2), reduced blood pressure and glucose levels in patients who used it, compared with those who did not.
Lose It, a weight loss app, is an electronic food journal that shows the values of the macronutrients of foods that the patient consumes, as well as a daily calorie count. The Engaging Everyday Activities (EEA) app effectively reminds patients who have had transient ischemic attacks about daily activities that can reduce their risk for a recurrent attack.
Movies4Stroke features educational videos about first aid, rehabilitation, how to improve swallowing, and stroke risk factors.
AFib 2gether allows patients to enter their clinical data and calculates their annual stroke risk scores. The information is provided to a healthcare provider before the next visit to help the patient make an informed decision about anticoagulation therapy.
The widespread use of smartphones and apps may improve patient care in every part of the world, and in particular in those parts where updated guideline consultation is not readily available.
There are some ways such apps could be particularly useful. One is in remote hospitals that might not have a neurologist. Helping with the diagnosis and determining what is a bad stroke that needs to go to a higher level of medical care, or whether it is something the local hospital could take care of, would be useful.