A 24-week Japanese RCT (N=70)134 compris- ing exercise, salt restriction, and nutrition advice compared with usual care terminated at a median follow-up of 2.9 years when the prespecified effi- cacy point for the intervention was reached for the primary end point (composite stroke death, cardiac death, and hospitalization for stroke recurrence, MI, angina pectoris, or peripheral artery disease; (adjusted HR, 0.194 [95% CI, 0.121 0.737]). Long-term effects (3.5 years) of an exercise and education program, compared with usual care in TIA or minor stroke patients (N=60), found that CLINICAL STATEMENTS AND GUIDELINES Kleindorfer within the intervention group, recurrent stroke, minor stroke, or TIA events were reduced com- pared with the usual care group (RR, 0.23 [95% CI, 0.07 0.72]; number needed to treat, 3) and a reduction in mortality associated with the inter- needed to treat, 8).131 2. Adhering to pharmacological secondary preven- tion strategies is an important self-care behavior in stroke secondary prevention. However, nonad- herence to medication regimens is reported in up to 40% of individuals with stroke.853 Multimodal interventions have been shown in a meta-analysis to improve compliance with antithrombotic medi- Self-management interventions have similarly shown a moder- ate effect size in adherence to prescribed sec- ondary prevention medications after stroke In the MIST phase III RCT (Motivational Interviewing in Stroke; N=386), improving adherence to secondary stroke preven- tion strategies through motivational interviewing demonstrated positive effects on self-reported medication adherence 9 months after stroke (RR, associated reduction in recurrent stroke (RR, 0.67 Assistive technology may play an emerging role. The SMS4Stroke (Short Messaging Service for Stroke) trial (N=200) showed an adjusted MD of 0.54 (95% CI, 0.22 0.85) in the Morisky Medication Adherence Scale score after 2 months of receiving short messaging service reminders for each dose of medication.843 3. 