To develop smartphone based medical application for delivering post stroke care and evaluate its efficacy in reducing post stroke complications. Patient Quality of life(QOL) and caregiver burden was evaluated.

Patients within 3 months of stroke were randomised prospectively in open labelled blinded endpoint (PROBE) study to either routine care (Controls) or App based care. Major inclusions were: Modified Rankin Score(mRS) >3, caregivers/patients with smartphone and internet facility and willing to use an app as health care tool. Major exclusions: Patients with no caregiver or hired/illiterate caregiver. MAPSS group was additionally given routine care with booklet. "Stoke Home Care" app was installed in caregiver smartphone and explained its use. Follow up was at 3 months which was blinded. We describe the Patient's Health related Quality of Life(HRQOL) and Caregiver stress (CSI).

166 patients were recruited (83 each group/one caregiver per patient). Mean age was 54.98±15.76 yrs and 73.5% males; 53% were ischemic strokes. 65% had mRS 5 with Median NIHSS 13(Both groups matched). At 3 months,3.6% MAPSS vs 6% controls lost to follow up, 12% MAPPS vs 24.1% controls were dead.33.8% MAPSS vs 56.4% controls developed at least one post stroke complication (composite) (P=0.004); 5% MAPSS vs 15.4% control had bedsore (P=0.031). Median HRQOL score was 68 (IQR: 50-80) in MAPSS vs 50 (IQR: 38-61) in controls (P=0.001); 5.7% caregivers in MAPSS had severe stress vs 27.6% controls(p=0.001); Median Caregiver Stress Index(CSI) was 9 (IQR: 5-13) in MAPSS vs 15 (IQR: 13-20) controls (P=0.001).

MAPPS was associated with better quality of life in severe strokes and led to lesser caregiver stress