Clinicians act to close regional stroke divide

Stroke Society calls for access to clot-dissolving treatments for all Australians

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'Geography is no longer an excuse for denying regional and rural Australians the treatments they need,' says stroke expert.


REGIONAL and rural Australians are being denied access to time-critical stroke treatments.

Leading stroke expert and president of the Stroke Society of Australasia, Professor Helen Dewey said stroke was treatable, but many Australians are being denied access to time-critical stroke treatments.

Professer Dewey was speaking at a the Stroke Society's annual conference in Canberra.

"As clinicians and researchers, we are standing together to say survival from stroke should no longer be determined by where you live,'' Professor Dewey said.

Around 450 leading stroke clinicians and researchers attended the conference, looking at ways to drive innovation and provide access to breakthrough blood clot dissolving and clot removal treatment.

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Currently, regional and rural Australians are 19 per cent more likely to experience a stroke than their city counterparts. Regional and rural Australians are also more likely to die or be left with significant disability as a result of stroke due to limited access to specialist treatment and care.

Innovations are extending treatment windows for stroke. Clot-dissolving treatment has now been shown to be beneficial up to nine hours from stroke symptom onset (up from 4.5 hours) and clot removal treatment has been shown to be beneficial up to 24 hours after stroke onset (up from six hours) in some patients.

Professor Dewey said all Australians should have access to these treatments.

"Clot-dissolving and clot removal treatment or reperfusion treatments, require specialist diagnosis and care,'' she said.

"Our city hospitals are best equipped to deliver and support this, however advances in technology and extended treatment windows mean geography is no longer an excuse for denying regional and rural Australians the treatments they need."

Solutions discussed at the meeting included the use of telehealth to increase access to emergency stroke treatment and rehabilitation, next steps for Australia's first Mobile Stroke Unit or Stroke Ambulance, and future emergency response innovations including adapting the Mobile Stroke Unit model for a plane or helicopter.

"We are working together to foster big picture solutions, as well as smaller changes we can make now at a local level to expedite access to time critical treatments,'' Prof Dewey said.

"This includes improving systems and protocols at local hospitals, implementing pre-notification tools that enable paramedics to communicate with hospitals, and using telehealth to boost capacity at our smaller hospitals while reducing unnecessary hospital transfers.

When a stroke strikes it attacks 1.9 million brain cells a minute. With treatment this damage can be stopped, but every minute, every second saved equals brain saved.

Stroke Foundation Chief Executive Officer Sharon McGowan said the was an opportunity to improve the stroke outcomes in this country and called on federal and stategovernments to stand with clinicians, researchers and the community.

"There is one stroke every nine minutes in this country. Stroke continues to kill more men than prostate cancer, more women than breast cancer and leave thousands with ongoing disabilities, yet stroke can be treated,'' Ms McGowan said.

"The National Action Plan for Heart and Stroke, which is currently being finalised, sets out clear solutions to address this disease, including those being discussed at Stroke 2019.

"We have proven solutions to ensure equality of access to emergency stroke treatment, and clinicians and researchers are working to address this issue.

"However, for us to have a real impact, governments must come together to address this disease."

Ms McGowan noted the Federal and New South Wales Governments were working towards a centralised stroke telehealth service. Victoria has a fully operational Victorian Stroke Telemedicine Program and pilot telestroke projects were underway in South Australia and Western Australia.

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