Background/Aims
The risk of recurrent stroke can be reduced through medications and lifestyle changes. However, many people have poor risk factor control after stroke. Our aim was to explore research and implementation priorities to address gaps in the secondary prevention of stroke in Australia.
Methods
Online stakeholder discussions were undertaken March 2023. Participants were people with lived experience of stroke, researchers, neurologists, general practitioners, allied health professionals, nurses, stroke advocacy organisations and government health department representatives. Participants were provided with prompts for their perceptions of priorities, barriers and facilitators to stroke secondary prevention. The discussions were recorded, transcribed and thematically analysed by one researcher with verification by collaborating researchers or health professionals.
Results
Twenty-five people participated (32% men; representing each state of Australia; 28% allied health, 14% nursing, 10% general practice, 16% neurology, 14% lived experience of stroke). Major themes were ‘models of care’, ‘coordination’, ‘resourcing’ and ‘research translation pipeline’. Models of care identified heterogeneous services covering lifestyle, exercise and/or pharmacotherapy, delivered in person or with eHealth with a lack of broad coverage. Successful programs were co-designed for personalized care. Barriers included poor implementation or uncertain effectiveness. Coordination of care was impacted by a fragmented health system and poor communication, but mitigated by ‘healthcare navigators’. Resourcing covered issues of sustainability, access, workforce capacity, and State/Federal funding dichotomies. The research translation pipeline lacked funding for implementation of effective programs.
Conclusion
The first Australian stroke secondary prevention roundtable revealed many implementation issues and opportunities, as well as strategies to overcome identified barriers.