Dr Monique Kilkenny's paper recognised as one of the most read in Medical Journal of Australia

Dr Monique Kilkenny

Congratulations to Dr Monique Kilkenny, whose ground breaking, multi-jurisdictional data linkage research which was published in the Medical Journal of Australia, has been recognised as one of the top downloaded publications in 2018-2019.

SCS researchers’ part of a team awarded $5 million to stop stroke in its tracks

Professor Amanda Thrift

Congratulations to SCS researchers from the Stroke and Ageing Group who have been successful in securing a five million dollar NHMRC Synergy Grant in collaboration with researchers at UTas, UWA and UniSA. Professors Amanda Thrift and Dominique Cadilhac, and Drs Monique Kilkenny and Joosup Kim received the grant for their project 'Synergies to Prevent Stroke – STOPstroke'.

Long-term support for stroke survivors under the microscope

Dr Joosup Kim

A Monash University researcher will investigate whether patients with stroke are getting the treatment and support they need to live well once they leave hospital and return home.

Dr Joosup Kim has received a $50,000 Stroke Foundation research grant for his project, which will focus on the quality of care provided by general practitioners (GPs) for patients with stroke once they are discharged from hospital.

Economic Evaluation of a Pre-Hospital Protocol for Patients with Suspected Acute Stroke

Joosup Kim, Dominique Cadilhac et al. published in Frontiers in Public Health.

Read article here.

Quality of Life Is Poorer for Patients With Stroke Who Require an Interpreter

Monique Kilkenny et al. published in Stroke.

Read article here.

Prescription of antihypertensive medication at discharge influences survival following stroke

Joosup Kim et al. published in Neurology.

Read article here.

Community-Based Intervention to Improve Cardiometabolic Targets in Patients With Stroke: A Randomized Controlled Trial

Muideen Olaiya et al. published in Stroke.

Read article here.

Long-term unmet needs and associated factors in stroke or TIA survivors: An observational study

Muideen Olaiya et al. published in Neurology.

Read article here.

Long-term unmet needs and associated factors in stroke or TIA survivors

Amanda Thrift et al. published in Neurology.

Read article here.

Improving care for patients with stroke impacts health outcomes and the economy

Associate Professor Cadilhac

Monash University researchers from Stroke and Ageing Research, School of Clinical Sciences at Monash Health, have shown that if acute stroke care was improved to that of Australian benchmarks, more than 9300 disability-adjusted life years could be avoided every year, at minimal cost to the health system.

Stroke is a leading cause of death and disability in Australia, and the associated economic burden is significant.

 “The average lifetime costs of first-ever stroke in Australia is approximately $100,000, comprising health costs and loss of productivity,” said senior researcher Associate Professor Dominique Cadilhac.

“While acute stroke treatment guidelines include stroke unit care, intravenous thrombolysis for patients with ischemic stroke and medication for secondary prevention, evidence suggests that eligible patients may not always receive these therapies—even in well-resourced settings.”

The research team estimated the health and economic benefits from improving standards of care, and converted their results to disability-adjusted life years (DALYs) avoided.  A DALY is a year of life lost due to illness, disability, or early death.

“Using 2013 patient data, we estimated that if hospitals had achieved the benchmark acute stroke care standards, 285 recurrent strokes and 977 deaths or disabilities would have been prevented,” said Dr Joosup Kim who did the modelling analysis.

“This translates to 9329 DALYs avoided; and these health benefits could be delivered at an additional cost of $30.8 million or approximately $3304 per DALY avoided.”

Dr Kim explained that considerable gains in health may be achieved at relatively low costs by improving the average standard of acute stroke care in Australia to the standard of top performing hospitals.

“The estimate of $3304 per DALY avoided is considered to be highly cost effective since the willingness to pay for an additional year of healthy life is generally accepted as less than the national annual gross domestic project per capita (approximately $50,000 in Australia).”

The evidence-based therapies included in the research team’s analysis are already recommended in guidelines, further emphasising the potential benefits of implementing current knowledge.

“These are benefits that could be achieved with investment in clinician behaviour change, health service redesign, and support structures within the clinical setting to attain achievable benchmarks,” said Associate Professor Cadilhac.

The potential health and economic impact of improving stroke care standards for Australia

Joosup Kim et al. published in the International Journal of Stroke.

Read article here.

Effectiveness of an Intervention to Improve Risk Factor Knowledge in Patients With Stroke

Muideen Olaiya et al. published in Stroke.

Read article here.

Nurse-Led Intervention to Improve Knowledge of Medications in Survivors of Stroke or Transient Ischemic Attack: A Cluster Randomized Controlled Trial

Amanda Thrift et al. published in Frontiers in Neurology.

Read article here.

Monash study reveals how to achieve better outcomes for hospitalised stroke patients

Assoc Prof Dominique Cadilhac

How patients with mini-stroke are managed in hospitals directly impacts their longer term survival, according to latest research from Monash University.

The practice of managing patients with acute stroke in specialised stroke units is already recommended, with the odds of death or dependency reduced by over 20% compared with management in an alternate hospital ward.

However, until now there has been limited data to support the best management of patients with transient ischemic attack (TIA) or mini-stroke if they require admission to hospital. 

Published this week in the high impact journal Neurology, the study led by School of Clinical Sciences’ Associate Professor Dominique Cadilhac and Dr Joosup Kim reveals that TIA patients requiring hospital admission and who are treated in a specialist stroke unit have a 45% reduced risk of death at 180 days compared with management in an alternate hospital ward.

“Stroke Unit care involves management by clinicians with specialist training and expertise in stroke who provide greater access to evidence-based care, including acute therapies and secondary prevention treatment,” said Associate Professor Cadilhac, Head of Translational Public Health and Evaluation Division, Stroke and Ageing Research.

“In alternate hospital wards, patients are managed by a range of health professionals who may not have specific expertise in stroke or TIA.”

“While some patients with TIA can be treated in a hospital emergency department and discharged with good specialist stroke follow-up, some require admission to hospital,” said Professor Velandai Srikanth, Head of Stroke and Ageing Research at Monash University and Monash Health stroke physician.

“Patients hospitalised with TIA have a high risk of stroke in the near future and need to be treated appropriately and quickly—preferably in a stroke unit.”

Using data obtained from the Australian Stroke Clinical Registry, Associate Professor Cadilhac and colleagues analysed more than 3000 TIA patient admissions from 40 hospitals between 2010 and 2013.

“Hospitalised patients with TIA managed in stroke units had better survival at 180 days than those treated in alternate wards, probably because of better risk management in a stroke unit setting,” said Associate Professor Cadilhac.

“This is the largest reported study of TIA outcomes after hospital admission according to the setting of patient management.”

“Overall, our findings provide evidence that Australian patients hospitalised for TIA are less often managed in a stroke unit than patients with a confirmed stroke, and that this practice should be reconsidered.”

Professor Srikanth said there are different models of care for patients with TIA in Australia.

“At Monash Medical Centre, the majority of patients with TIA are rapidly investigated and treated in the emergency department according to a carefully designed and effective stroke unit protocol, and followed up in specialist TIA outpatient clinics run by stroke specialists.”

“Patients requiring hospital admission are usually managed by the stroke unit specialists – and the data from this important study supports the practice at Monash Health,” added Professor Srikanth.

“Improving availability of specialised stroke care in Australia, and elsewhere, will improve the management of patients hospitalised with TIA,” said Associate Professor Cadilhac.

“For the first time, these findings provide evidence that patients with TIA who require admission and are treated in a stroke unit have improved longer-term survival rates.”