Poster The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

What can we learn from websites for people with chronic illness to help survivors of stroke manage their cardiovascular risk factors? A Systematic Review and Meta-Analysis. (#189)

Dina Pogrebnoy 1 2 , Amy Dennett 3 , Dawn Simpson 2 , Lesley MacDonald-Wicks 2 , Amanda Patterson 2 , Coralie English 2
  1. Physiotherapy, Western Health, Melbourne, Victoria, Australia
  2. School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia
  3. Office of Research, Eastern Health, Melbourne, Victoria, Australia

Background: Survivors of stroke need accessible resources to manage their cardiovascular risk factors. Self-directed websites may help manage the ongoing cardiovascular risk after stroke but there are no stroke specific websites to support survivors in self-management.

Aims: Evaluate whether using self-directed websites can improve physical activity and/or diet quality in people living with chronic illness to see what might be applicable for survivors of stroke.

Methods: A search was conducted in MEDLINE, EMBASE, CINAHL and PEDro from earliest available time to 3rd of February 2023 to identify randomized controlled trials evaluating the effectiveness of self-directed websites on physical activity levels and/or diet quality in adults living with chronic illness. Quality of life and/or self-efficacy data was extracted where reported. Two independent reviewers completed data extraction. Risk of bias was assessed using the Physiotherapy Evidence Database Scale, and overall quality of evidence was assessed using the Grades of Research, Assessment, Development, and Evaluation approach.

Results:Thirty studies were included with data from 6106 participants pooled for meta-analysis. We found moderate level evidence that self-directed websites significantly improve physical activity levels (MD 41.45minutes per week, 95% CI [22 to 61]; N=16 trials, n=3012), quality of life (SMD 0.36, 95% CI [0.12 to 0.59]) and self-efficacy (SMD 0.26, 95% CI [0.05 to 0.48]) when compared to usual care. There was high level evidence for reduction in processed meat consumption (MD 1.14 portions per week, 95% CI [0.70 to 1.58]; N=2 trials, n=109). No significant differences were detected for other outcomes when compared to usual care, or when comparing self-directed websites to websites with additional supports.

Conclusion: Engaging with self-directed websites can improve physical activity levels, quality of life, self-efficacy and diet quality in people living with chronic illness. Our findings support the development and implementation of targeted websites for risk factor management in stroke.