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Australian Stroke Foundation UpdateSharon McGowan19 October 2019

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Stroke Foundation National Audit A 20 year retrospective

In Australia, over the last 20 years:

• Advancements in acute stroke treatments mean more Australians are surviving stroke than ever before.

• Improvements to the quality of stroke rehabilitation care have been limited.

Globally, stroke is increasing

• 1 in 4 people will experience stroke in their lifetime.

• 58 percent of all strokes happen in people aged 70 and under

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National Acute Audit 2019 Results

120…acute servicesReporting 35,164 admissions4176 cases audited (11.8%)

11 sites from WA reporting 2,979 admissions 349 cases audited (11.7%)

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SummaryAchievable Benchmark

Achievable Benchmark

Discharge Care Plan

Received Stroke Unit Care

Reperfusion therapy:148 reported thrombolysis annually (6% national)

283 reported ECR annually (15% national & second highest state per population)

Thrombolysis in ischaemic stroke (clinical audit)Achievable Benchmark

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National Action Plan for Heart and Stroke

• Developed by Stroke Foundationand Heart Foundation with significant input from key stakeholders.

• Outlines immediately achievable actions Australian governments at all levels can implement to reduce the impact of stroke.

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10-year Mission for Cardiovascular Health

• $220m investment by Medical Research Future Fund• Six Flagship areas: Drug discovery Bioengineering Precision medicine Data Clinical trials Implementation and policy

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Out of Hospital Cardiac Arrest (OHCA) ‘Chain of survival’ adapted for stroke

Image courtesy of David Waters, CEO Council of Ambulance Authorities

Australia’s first Stroke Ambulance• 2579 dispatches• 1025 attended and assessed patients• 45% scanned in vehicle• 47% ischaemic stroke thrombolysed• 1 in 7 treated within 60mins• 1 in 5 transferred for thrombectomy

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MRFF Frontiers Program

Australian Stroke Alliance

• $1 million over 12 months to develop detailed plan for a transformative stroke research program.

• Aims to develop, test and implement breakthrough portable imaging technologies to transform access to early pre-hospital treatments.

Australian Telehealth NetworkHarnessing technology and fostering innovation to enhance access to stroke treatment for all Australians

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• 39 active telestroke sites (excluding NSW)• 5 telestroke ready sites (infrastructure available)• 21 potential sites (based on stroke throughput

and population characteristics• WA and NSW implementing telestroke• SA pilot ongoing• VIC expanding service to cover TAS• QLD and NT – no formal service

Living Guidelines go live!• Use ‘evidence surveillance’

systems that continually scan for new research – AI, Cochrane Crowd and Covidence

• Goal is to create a near real-time, closed-loop evidence system

• Guideline recommendations will continue to be developed and published using the MAGICappplatform.

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Extended time window for ‘Time is brain’ acute stroke treatments

Thrombolysis• Extended from 4.5 to 9 hours from stroke onset (EXTEND trial).

Endovascular thrombectomy• Extended from six to 16 hours (24 hours under certain conditions)

from stroke onset (DAWN and DEFUSE 3 trials).

New NDIS resources developed•Resources developed in partnership with stroke survivors and NDIS service providers

•New EnableMe page connecting stroke survivors to health and disability pathways, including employment services, local NDIS providers and StrokeLine.

•Nine videos and two podcasts about emotional adjustment, getting back to work and navigating the NDIS.

•A 30 day marketing campaign with four video advertisements.

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World Stroke Day Campaign 2019

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Think FAST, Act FAST