The Stroke Foundation, Australia
The Stroke Foundation, Australia has for the last two decades worked to support stroke survivors and their families. As ‘the voice of stroke’ in Australia, the national charity is working to increase community awareness and understanding of how stroke can be prevented, and how recognising the signs of stroke and getting access to treatment quickly can improve outcomes. It also aims to support healthcare practitioners and researchers to develop new innovative ways to prevent and treat stroke and promote rehabilitation, improving quality of life for survivors. In this exclusive interview, the Chief Executive Officer of the Stroke Foundation, Australia, Sharon McGowan tells us about their work with the community to prevent, treat and beat stroke. She explains how the Foundation works alongside stroke survivors and their families, healthcare professionals and researchers, to build community awareness and foster new thinking. Their aim is to support survivors on their journey to live the best possible life after stroke.
Can you tell us why it’s important to support research into stroke prevention, treatment and rehabilitation in Australia and across the world?
Stroke is a largely preventable and treatable disease. Yet, stroke is a leading cause of death and disability globally. Research will help us beat it.
Over the past two decades, the massive advances we’ve witnessed in the diagnosis and treatment of acute stroke have led to a significant reduction in the lives lost to this terrible disease. Stroke may no longer be the death sentence it once was, but for the 26 million stroke survivors globally and the more than 475,000 stroke survivors living in the Australian community its impacts are far reaching and life-changing.
There is still so much we don’t know about the mysteries of the brain. Twenty five percent of stroke causes are unknown. Breakthroughs in stroke prevention, treatment and recovery are needed now more than ever.
‘There has been a consistent lack of stroke-specific funding and poor resourcing costing us lives and money.’
Please describe the areas of research you are currently supporting and your research priorities.
The Stroke Foundation Research and Innovation Fund supports the translation of high quality research into changes in practice, policy and knowledge – research that can translate into improving real world practice.
The Stroke Foundation provides grants to support early-to-middle career researchers to expand our collective knowledge and understanding about stroke. We focus on this group to fulfil our aim to increase capacity in research on stroke. We also focus on areas where there is a recognised gap in evidence and knowledge.
By providing seed grants, we empower clinicians, health professionals and scientists to explore their research questions, to test their concepts and implement their innovative ideas. We also support clinicians, health professionals and scientists to follow research as a chosen career.
The results, data and evidence from research support by the Stroke Foundation assists participants in securing much larger, longer-term research grants from other funding organisations. We also partner with hospitals, research institutes and other major organisations to fund multi-disciplinary national and international trials.
Current research priorities are – long term stroke recovery support. This includes transition of care from hospital to a general practitioner, follow-up interventions to assist patients once at home and long-term support to reduce their unmet needs.
High quality acute stroke care. This particularly addresses aspects of care highlighted in the Clinical Guidelines for Stroke Management that are considered best-practice care, e.g., access to stroke unit care, and time critical treatment. The aim is to facilitate translation into practice. And finally, support for Carers as this is important for the health and well-being of survivors of stroke as well as caregivers themselves.
Can you briefly tell us about Associate Professor Bruce Campbell’s research using brain imaging to aid procedures to remove clots from the brain, which has been hailed as a breakthrough?
The Stroke Foundation Research and Innovation Fund combined with the Heart Foundation, Royal Melbourne Hospital Foundation and NHMRC (National Health and Medical Research Council) has supported pioneering research to improve treatment of ischaemic stroke patients with large blocked vessels in the brain in whom standard clot-busting medication is less effective.
Hailed as a major breakthrough, Associate Professor Bruce Campbell’s research combined advanced brain imaging of ischaemic stroke patients to identify those who could benefit from restoring blood flow with a minimally invasive procedure. This delicate microscopic surgery removes the clot that is blocking blood supply to the brain and caused the stroke.
When combined with traditional clot-dissolving treatment, this innovative new approach led to 70 percent of patients returning to independent living, as compared with 40 percent of patients who received the standard treatment.
Crucially this case study demonstrates how evidence-based research is needed to effect significant changes in traditional stroke treatment. Research has the power to save lives, prevent disability and ultimately reduce the burden of stroke on our community.
‘There has been a consistent lack of stroke-specific funding and poor resourcing costing us lives and money.’
As well as supporting research projects, tell us how you work to inform public and political opinion and influence policy to improve standards of stroke care in Australia?
The Stroke Foundation is the voice of stroke in Australia. We work to raise the awareness of stroke, facilitate research and support stroke survivors.
Through the national audit program, the Stroke Foundation accesses a snapshot of stroke treatment and care in Australia. It provides a measure of adherence to important aspects of care recommended in the Clinical Guidelines for Stroke Management. The latest update to the Guidelines was launched this September, including 250 recommendations for stroke treatment and care; starting in the ambulance and progressing through hospital and rehabilitation to the transition home.
We also partner with the community to deliver a number of key awareness campaigns throughout the year. These include Australia’s Biggest Blood Pressure Check and National Stroke Week. This year for Australia’s Biggest Blood Pressure Check we delivered more than 56,000 health checks across the country helping people learn more about stroke and identify and manage their stroke risk. Stroke Week is held in September each year, and thousands of community events are held across the country. This year we focused on educating people on the signs of stroke F.A.S.T.
The FAST test is an easy way to recognise and remember the signs of stroke. Using the FAST test involves asking these simple questions:
Face – Check their face. Has their mouth drooped?
Arms – Can they lift both arms?
Speech – Is their speech slurred? Do they understand you?
Time – Time is critical. If you see any of these signs, call an ambulance straight away.
We build on these campaigns with activities and advocacy throughout the year. The Stroke Foundation also operates a dedicated website for the stroke community called EnableMe (www.enableme.org.au) which provides them with an avenue to communicate with other stroke survivors and access fact sheets, and one for the clinical community called InformMe (www.informme.org.au) which keeps members up to date on stroke developments.
Can you tell us more about the National Stroke Audit and its importance for clinicians and researchers and other projects where the use of data and information is being applied?
The Stroke Foundation’s national audit program provides a comprehensive snapshot of stroke treatment and care in Australia. The Stroke Foundation collects and evaluates data on the delivery of stroke care using standard indicators based on the best-practice recommendations of the Clinical Guidelines, as well as Stroke Service Frameworks and Acute Stroke Clinical Care Standard.
The National Stroke Audit is conducted annually but alternates between acute and rehabilitation services. Stroke clinicians can access their audit data online via InformMe and use it to benchmark their performance and use the tools provided to improve performance on key criteria.
The Stroke Foundation also played a key role in the development of the Australian Acute Stroke Clinical Care Standard. The Standard enhances the Clinical Guidelines and aims to support the delivery of appropriate care, reduce unwarranted variation in care, and promote shared decision making between patients, carers and clinicians.
‘The Stroke Foundation Research and Innovation Fund supports the translation of high quality research into changes in practice, policy and knowledge – research that can translate into improving real world practice.’
Tell us more about how you support the early career development of researchers.
The Stroke Foundation focuses its grants program on early to mid-career researchers. These are the researchers who find it hardest to gain funding to support their research careers, and so by supporting these researchers we are contributing to building capacity in research in stroke. We provide relatively small amounts of funding to conduct pilot or feasibility studies. The grants provide an opportunity for researchers to take their first step towards a big idea.
By providing seed grants, we empower clinicians, health professionals and scientists to explore their research questions, to test their concepts and implement their innovative ideas. We also support clinicians, health professionals and scientists to follow research as a chosen career. The results, data and evidence from research support by the Stroke Foundation assists participants in securing much larger, longer-term research grants from other funding organisations.
Finally, what do you see as the biggest challenges facing clinicians and researchers working to prevent and treat stroke in the next ten years? Tell us about your longer-term plans to tackle these challenges.
The stroke challenge is looming large for our communities and the health system in Australia. Today, there is one stroke every nine minutes within Australia, by 2050 this number is set to increase to one stroke every four minutes. Like many countries around the globe our population is ageing.
Stroke is a largely preventable and treatable disease. Research has seen significant advancements in stroke however, currently only a small percentage of Australian stroke patients are getting access to the latest treatments and ongoing specialist care that we know saves lives.
We know regional Australians are 19 percent more likely to suffer a stroke than their metropolitan counterparts. Due to limited access to best practice treatment, regional Australians were also more likely to die or be left with a significant disability as a result of stroke.
It doesn’t need to be this way. There has been a consistent lack of stroke-specific funding and poor resourcing costing us lives and money. Health professionals are doing their best in a health system that is already stretched. If action is not taken now to address stroke prevention and inequality of care imagine the burden in 2050.
The Stroke Foundation has called for a funded national action plan to address the prevention and treatment of stroke, and support for stroke survivors living in the community.
Key elements included a national action plan to promote absolute risk assessment of cardiovascular disease for adults aged 45–74 years and from 35 years for Aboriginal and Torres Strait Islanders. A national action campaign to ensure every Australian household has someone who knows FAST – the signs of stroke and to call an ambulance. Stroke is a time critical medical condition.
Time saved in getting people to hospital and treatments = brain saved.
The action plan also includes a nationally coordinated telemedicine network – breaking down the barriers to acute stroke treatment. Working to ensure all stroke patients have access to stroke unit care, and spend enough time on the stroke unit accessing the services and support they need to live well after stroke.
Finally, it also includes development of ‘Living’ Clinical Guidelines for Stroke Management to accelerate world class treatment and care for Australians with stroke, ensuring the latest advancements in research are translated into clinical practice.