• Jamuna Rani Appalasamy, Kyi Kyi Tha, Kia Fatt Quek, RamaiahSiva SeetaSS, Joyce Pauline Joseph, and Anuar Zaini Md Zain.
• Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia Subang Jaya Medical Centre, Jalan SS12/1a, Selangor Neurology Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
• Medicine (Baltimore). 2018 Jun 1; 97 (22): e10876e10876.

IntroductionA substantial number of the world's population appears to end with moderate to severe long-term disability after stroke. Persistent uncontrolled stroke risk factor leads to unpredicted recurrent stroke event. The increasing prevalence of stroke across ages in Malaysia has led to the adaptation of medication therapy adherence clinic (MTAC) framework. The stroke care unit has limited patient education resources especially for patients with medication understanding and use self-efficacy. Nevertheless, only a handful of studies have probed into the effectiveness of video narrative at stroke care centers.MethodThis is a behavioral randomized controlled trial of patient education intervention with video narratives for patients with stroke lacking medication understanding and use self-efficacy. The study will recruit up to 200 eligible stroke patients at the neurology tertiary outpatient clinic, whereby they will be requested to return for follow-up approximately 3 months once for up to 12 months. Consenting patients will be randomized to either standard patient education care or intervention with video narratives. The researchers will ensure control of potential confounding factors, as well as unbiased treatment review with prescribed medications only obtained onsite.ResultsThe primary analysis outcomes will reflect the variances in medication understanding and use self-efficacy scores, as well as the associated factors, such as retention of knowledge, belief and perception changes, whereas stroke risk factor control, for example, self-monitoring and quality of life, will be the secondary outcomes.Discussion And ConclusionThe study should be able to determine if video narrative can induce a positive behavioral change towards stroke risk factor control via enhanced medication understanding and use self-efficacy. This intervention is innovative as it combines health belief, motivation, and role model concept to trigger self-efficacy in maintaining healthy behaviors and better disease management.Trial RegistrationACTRN (12618000174280).

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