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MEDLINE, Embase, article references, and 10 additional databases/ Future research should focus on the development/evaluation of
clinical trials registers.1 more effective interventions to translate secondary prevention
recommendations into practice. Interventions included in this
Results review differed considerably on aims, components, and mode
A total of 42 randomized controlled trials involving 33 840 par- of delivery. Predetermined strategies for categorizing interven-
ticipants were included. Organizational interventions (including tions and their intensity may facilitate the synthesis of future
education) were evaluated in 26 studies. The most common inter- research findings. There is also a need to evaluate the effects of
ventions were the introduction of integrated care services and specific components of organizational interventions, including
collaboration between multi-disciplinary teams. Educational/ the characteristics of an effective multidisciplinary team. We
behavioral interventions were evaluated in 16 studies, largely identified 24 ongoing studies and 11 studies that are awaiting
focused on patients rather than service providers. GRADE assessment, demonstrating ongoing interest in this area.
approach assessed 3 studies as high risk of bias and the remain-
der as low. Although clinical and methodological heterogeneity Acknowledgments
was present, results were pooled where appropriate. This paper is based on a Cochrane Review published in The Cochrane
Library 2018, Issue 5 (www.thecochranelibrary.com for information).
Cochrane Reviews are regularly updated as new evidence emerges
Discussion and in response to feedback, and The Cochrane Library should be
Educational/ behavioral interventions showed no clear differ- consulted for the most recent version of the review.
ences on any of the review outcomes.
Organizational interventions resulted in improvements Disclosures
to achieve target blood pressure (odds ratio, 1.44; 95% con- Dr Bridgwood was awarded a National Institute for Health
fidence interval, 1.09–1.90; 13 studies; 23 631 participants; Research (NIHR) fellowship. Dr Mistri has received speaker fees/
Received June 21, 2018; final revision received July 8, 2018; accepted July 26, 2018.
From the Department of Health Sciences (B.B., K.E.L., A.D.W.), Department of Cardiovascular Sciences (A.K.M.), and Diabetes Research Centre
(K.K.), University of Leicester, Leicester, United Kingdom; and Faculty of Medicine, Charles University, Prague (P.M.).
Correspondence to Andrew D. Wilson, MD, Department of Health Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom. Email
aw7@leicester.ac.uk
(Stroke. 2018;49:e301-e302. DOI: 10.1161/STROKEAHA.118.022213.)
© 2018 American Heart Association, Inc.
Stroke is available at https://www.ahajournals.org/journal/str DOI: 10.1161/STROKEAHA.118.022213
e301
e302 Stroke October 2018
Figure. Organizational interventions vs usual care illustrating blood pressure target achievement.