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.