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Real-world, feasibility study to investigate the use of a multidisciplinary app (Pulsara) to improve prehospital communication and timelines for acute stroke/STEMI care
Conclusions In this Australian-first study, uptake of the digital communication app was strong, patient-centred care timelines improved, although door-to-treatment times remained similar.
Source: BMJ Open - July 18, 2022 Category: General Medicine Authors: Bladin, C. F., Bagot, K. L., Vu, M., Kim, J., Bernard, S., Smith, K., Hocking, G., Coupland, T., Pearce, D., Badcock, D., Budge, M., Nadurata, V., Pearce, W., Hall, H., Kelly, B., Spencer, A., Chapman, P., Oqueli, E., Sahathevan, R., Kraemer, T., Hair, C. Tags: Open access, Communication Source Type: research

Promoting adherence to stroke secondary prevention behaviours by imparting behaviour change skills: protocol for a single-arm pilot trial of Living Well After Stroke
Introduction Survivors of stroke have an elevated risk of recurrent stroke. Prompt intervention to support healthy lifestyle modification following an initial stroke is crucial for effective secondary prevention of stroke. However, many patients do not receive adequate postdischarge support for secondary prevention, particularly if not referred to inpatient rehabilitation. Living Well After Stroke is a health promotion programme based on the health action process approach (HAPA), which is designed to support this underserviced group to improve and self-manage secondary prevention behavioural performance (eg, diet, exercise...
Source: BMJ Open - January 24, 2023 Category: General Medicine Authors: Smith, S., Parkinson, J., Caitens, T., Sanders, A., Murphy, L., Hamilton, K. Tags: Open access, Public health Source Type: research

Acupuncture for gait disturbance of patients with subacute and chronic stroke: a systematic review and meta-analysis protocol
Introduction Hemiparetic gait is one of the most common sequelae of a stroke. Acupuncture has shown potential in correcting hemiplegic gait patterns and improving motor function recovery after stroke. However, controversial findings and a lack of supportive evidence on the effectiveness of acupuncture for post-stroke hemiplegia. The intelligent gait analysis system provides a new perspective for the study of hemiparetic gait. This systematic review aims to collect relevant studies and critically evaluate the efficacy and safety of acupuncture in alleviating gait disturbance of post-stroke hemiplegia based on quantified gai...
Source: BMJ Open - June 21, 2023 Category: General Medicine Authors: Sun, Z., Lin, Y.-r., Lu, M.-j., Huang, K.-y., Sun, K., Zhang, J.-b. Tags: Open access, Rehabilitation medicine Source Type: research

Reflecting on experiences of care: an exploratory qualitative descriptive study of the perspectives of stroke survivors, families and staff
Conclusion Seeking patient, family and staff experiences of care can provide valuable insights into facilitating better patient, family and staff engagement for preparation for home-based rehabilitation for stroke survivors and their caregivers. Further research with a larger sample across diverse hospital settings would provide even greater insight into strategies to best address the reality of rehabilitation care and readiness of patients when returning home to the community.
Source: BMJ Open - December 20, 2021 Category: General Medicine Authors: Bulsara, C., Saunders, R., Emery, L., Etherton-Beer, C. Tags: Open access, Rehabilitation medicine Source Type: research

Using body cameras to quantify the duration of a Code Stroke and identify workflow issues: a continuous observation workflow time study
Conclusions Codes are time intensive. Time spent on decision-making was a relatively small component of the overall Code duration. Data from body cameras can provide granular data on all aspects of Code workflow to inform potential areas for improvement at individual centres.
Source: BMJ Open - January 25, 2023 Category: General Medicine Authors: Wong, J. Z. W., Park, P. S. W., Frost, T., Stephens, K., Newk-Fon Hey Tow, F. K., Garcia, P. G., Senanayake, C., Choi, P. M. C. Tags: Open access, Neurology Source Type: research

Effect of occupational therapy home visit discharge planning on participation after stroke: protocol for the HOME Rehab trial
This study is approved by the Alfred Health Human Research Ethics Committee and site-specific ethics approval has been obtained at all participating sites. Results of the main trial and the secondary endpoint of cost-effectiveness will be submitted for publication in peer-reviewed journals Trial registration number ACTRN12618001360202
Source: BMJ Open - July 5, 2021 Category: General Medicine Authors: Lannin, N. A., Clemson, L., Drummond, A., Stanley, M., Churilov, L., Laver, K., O'Keefe, S., Cameron, I., Crotty, M., Usherwood, T., Andrew, N. E., Jolliffe, L., Cadilhac, D. A. Tags: Open access, Rehabilitation medicine Source Type: research

Development of strategies to support home-based exercise adherence after stroke: a Delphi consensus
Conclusion We developed a framework of comprehensive strategies to assist clinicians in supporting exercise adherence among stroke survivors. It provides practical methods that can be deployed in both research and clinical practices. Future studies should explore stakeholders’ experiences and the cost-effectiveness of implementing these strategies.
Source: BMJ Open - January 6, 2022 Category: General Medicine Authors: Mahmood, A., Deshmukh, A., Natarajan, M., Marsden, D., Vyslysel, G., Padickaparambil, S., TS, S., Direito, A., Kumaran, S., N, G., Sachdev, H., Kumar Veluswamy, S., Karthikbabu, S., Unnikrishnan, B., English, C., Solomon, J. M. Tags: Open access, Neurology Source Type: research

Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk
Introduction Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual’s risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the ...
Source: BMJ Open - September 22, 2023 Category: General Medicine Authors: Kootar, S., Huque, M. H., Kiely, K. M., Anderson, C. S., Jorm, L., Kivipelto, M., Lautenschlager, N. T., Matthews, F., Shaw, J. E., Whitmer, R. A., Peters, R., Anstey, K. J. Tags: Open access, Public health Source Type: research

Using experience-based codesign to coproduce aphasia rehabilitation services: study protocol
We present a protocol for the development of coproduced aphasia service elements. We will use experience-based codesign (EBCD), an approach that enables service users and providers to collaboratively develop services and care pathways. Drawing on the experiences of people with aphasia, their families and clinicians we will establish priorities for the development of new services and later work together to codesign them. Methods and analysis This research will be coproduced with people with aphasia (n=30–60), their families (n=30–60) and speech pathologists (n=30–60) in Queensland, Australia, using EBCD. ...
Source: BMJ Open - November 18, 2021 Category: General Medicine Authors: Anemaat, L., Palmer, V. J., Copland, D. A., Mainstone, K., Druery, K., Druery, J., Aisthorpe, B., Binge, G., Mainstone, P., Wallace, S. J. Tags: Open access, Rehabilitation medicine Source Type: research

Healing Right Way: study protocol for a stepped wedge cluster randomised controlled trial to enhance rehabilitation services and improve quality of life in Aboriginal Australians after brain injury
This study will test the impact of a research-informed culturally secure intervention model for Aboriginal people with brain injury. Methods and analysis Design: Stepped wedge cluster randomised control trial design; intervention sequentially introduced at four pairs of healthcare sites across Western Australia at 26-week intervals. Recruitment: Aboriginal participants aged ≥18 years within 4 weeks of an acute stroke or traumatic brain injury. Intervention: (1) Cultural security training for hospital staff and (2) local, trial-specific, Aboriginal Brain Injury Coordinators supporting participants. Primary outcome: Qual...
Source: BMJ Open - September 28, 2021 Category: General Medicine Authors: Armstrong, E., Coffin, J., Hersh, D., Katzenellenbogen, J. M., Thompson, S., Flicker, L., McAllister, M., Cadilhac, D. A., Rai, T., Godecke, E., Hayward, C., Hankey, G. J., Drew, N., Lin, I., Woods, D., Ciccone, N. Tags: Open access, Health services research Source Type: research

Feedback of aggregate patient-reported outcomes (PROs) data to clinicians and hospital end users: findings from an Australian codesign workshop process
Conclusions Our research provides guidance on PROs reporting for optimising data interpretation and comparing hospital performance.
Source: BMJ Open - July 1, 2022 Category: General Medicine Authors: Ryan, O. F., Hancock, S. L., Marion, V., Kelly, P., Kilkenny, M. F., Clissold, B., Gunzburg, P., Cooke, S., Guy, L., Sanders, L., Breen, S., Cadilhac, D. A. Tags: Open access, Health services research Source Type: research

Impact of multimorbidity and complex multimorbidity on mortality among older Australians aged 45 years and over: a large population-based record linkage study
Conclusion MM and CMM were common in older Australian adults; and MM was a better predictor of all-cause mortality risk than CMM. Higher mortality risk in those aged 45–59 years indicates tailored, person-centred integrated care interventions and better access to holistic healthcare are needed for this age group.
Source: BMJ Open - July 26, 2022 Category: General Medicine Authors: Kabir, A., Tran, A., Ansari, S., Conway, D. P., Barr, M. Tags: Open access, Geriatric medicine Source Type: research

Factors associated with discharge from hospital to residential aged care for younger people with neuropsychiatric disorders: an exploratory case-control study in New South Wales, Australia
Conclusions There are multiple intersecting and interacting pathways culminating in discharge from hospital to RAC among younger people with neuropsychiatric disorders. Improved capacity for interdisciplinary home care and alternative housing and support options for people with high support needs are required.
Source: BMJ Open - December 1, 2022 Category: General Medicine Authors: Cvejic, R. C., Watkins, T. R., Walker, A. R., Reppermund, S., Srasuebkul, P., Draper, B., Withall, A., Winkler, D., Honan, I., Mackechnie, D., Trollor, J. Tags: Open access, Epidemiology Source Type: research

Primary healthcare needs and service utilisation of people with disability: a data linkage protocol
Introduction General practitioners (GPs) play a crucial role in the early management and treatment of the comorbidities and complications experienced by people with disability. However, GPs experience multiple constraints, including limited time and disability-related expertise. Knowledge gaps around the health needs of people with disability as well as the frequency and extent of their engagement with GPs mean evidence to inform practice is limited. Using a linked dataset, this project aims to enhance the knowledge of the GP workforce by describing the health needs of people with disability. Methods and analysis This pro...
Source: BMJ Open - April 19, 2023 Category: General Medicine Authors: Douglas, J., Winkler, D., McLeod, A., Oliver, S., Gardner, K., Supple, J., Pearce, C. Tags: Open access, Health services research Source Type: research