Strengths and limitations
stroke, ischaemic stroke
ATRIAL FIBRILLATION, STROKE, SECONDARY, ISCHAEMIC STROKE
This study has several strengths. First, the cross-over design of our study enabled each patient to serve as their own control. When investigating individual behaviours, this design delivers more robust results than inter-individual comparisons because the risk of confounders is negligible. We observed no time trends or carry-over effects between the cross-over phases, which supports the appropriateness of our design. Second, our study population was a well-described and homogeneous sample of patients treated with DOAC for secondary prevention due to a recent ischaemic stroke attributable to atrial fibrillation. Reminders increased adherence in this specific sample and should therefore be offered to these patients after suffering a stroke. Third, we used electronic monitoring to assess adherence, which is considered the gold standard when investigating the implementation of a medicine. The Smart cards delivered accurate information on intake times, which was crucial to judging the impact of reminders on timely DOAC intakes.There were also limitations to this study. First, the primary outcome (