UNIverse - Public Research Portal
Project cover

Electronic Monitoring and Improvement of Adherence to DOACs in Polymedicated Stroke Patients (MAAESTRO)

Research Project
 | 
01.12.2017
 - 31.12.2023

Primary objective of the MAAESTRO trial is to evaluate the impact of an educational and reminder-based intervention on the adherence of stroke patients to direct oral anticoagulants (DOACs). Secondary objectives are to evaluate the association between non-adherence and clinical events, to identify predictors of non-adherence and to compare objective measures of adherence with self-reporting. Key methodological instrument for this study will be the electronic device "Time4Med" as Smart and Reminder Card affixed on a pillbox. The study includes 3 visits (baseline visit 0, follow-up visit 1, end-of-study visit 2) with a total follow-up of 12 months. After an initial 6-month observational phase with electronic monitoring of adherence using the "Smart Card", all patients will receive counselling based on their electronically recorded drug intake data, as well as a multicompartment pillbox. Patients will be then randomised to one of two groups in a crossover design, so that in the subsequent 6-month interventional phase one group will use a (reminder-delivering) "Reminder Card" for the first 3 months and the "Smart Card" for the last 3 months, while the second group will use the cards in reverse order.

Publications

Rekk, Katharina et al. (2024) ‘Relationship between electronically monitored adherence to direct oral anticoagulants and ischemic or hemorrhagic events after an initial ischemic stroke-A case control study’, PLoS ONE, 19(4 April). Available at: https://doi.org/10.1371/journal.pone.0301421.

URLs
URLs

Dietrich, Fine et al. (2024) ‘Intake reminders are effective in enhancing adherence to direct oral anticoagulants in stroke patients: a randomised cross-over trial (MAAESTRO study)’, Journal of Neurology, 271(2), pp. 841–851. Available at: https://doi.org/10.1007/s00415-023-12035-z.

URLs
URLs

Dietrich F et al. (2022) ‘Impact of the COVID-19 lockdown on the adherence of stroke patients to direct oral anticoagulants: a secondary analysis from the MAAESTRO study’, Journal of Neurology, 269(1), pp. 19–25. Available at: https://doi.org/10.1007/s00415-021-10631-5.

URLs
URLs

Albert V et al. (2021) ‘Insights Into Direct Oral Anticoagulant Therapy Implementation of Stroke Survivors with Atrial Fibrillation in an Ambulatory Setting’, Journal of Stroke and Cerebrovascular Diseases, 30(2), p. 105530. Available at: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105530.

URLs
URLs

Polymeris, Alexandros A. et al. (2018) ‘Protocol for MAAESTRO: Electronic Monitoring and Improvement of Adherence to Direct Oral Anticoagulant Treatment-A Randomized Crossover Study of an Educational and Reminder-Based Intervention in Ischemic Stroke Patients Under Polypharmacy’, Frontiers in Neurology, 9, p. 1134. Available at: https://doi.org/10.3389/fneur.2018.01134.

URLs
URLs

Members (5)

Profile Photo

Isabelle Arnet

Principal Investigator
Profile Photo

Philippe Lyrer

Principal Investigator
Profile Photo

Alexandros Polymeris

Co-Investigator
Profile Photo

Valerie Albert

Project Member
Profile Photo

Fine Michèle Dietrich

Project Member