Asia Pacific roundtable addresses gaps in national stroke targets 30/60/90

Pharma News: In Australia, stroke is the third most common cause of death and a leading cause of disability. Timely reperfusion therapies significantly enhance treatment outcomes.

Research shows that for every minute saved in administering thrombolytic treatment, patients gain an extra day of quality-adjusted life, while endovascular thrombectomy (EVT) offers an additional week.

However, despite Australia’s national stroke standards and registry, the country falls short in international comparisons when it comes to stroke unit admissions and the speed of reperfusion treatments.

In 2022, Australia’s median door-to-needle time for thrombolysis was 75 minutes, with only 27% of patients receiving treatment within the crucial first hour of hospital arrival. In contrast, Sweden achieved 82%, the United States 75%, and the United Kingdom 61%.

Alarmingly, Australia’s performance on door-to-needle times and stroke unit admissions has stagnated over the past six years. These delays are particularly pronounced in regional and remote areas, where treatment gaps are most severe.

In a bid to reverse this trend, clinical stroke leaders from across the country met this week at the National Targets Roundtable Meeting, held as part of the Asia Pacific Stroke Conference. This gathering marked the first major discussion since last year’s alignment on national stroke targets of 30/60/90*.

Stakeholders reviewed progress, discussed obstacles, and stressed the critical role of national quality monitoring. The meeting also included presentations on best practices from countries such as Vietnam, Singapore, and South Korea.

“It was truly inspiring to see the incredible work that has been implemented and the progress that has been made. While we acknowledge that there is still much to be done to fully realise our targets, the dedication and collaboration displayed at this meeting give us great hope for the future,” said Kim Malkin, Angels Initiative Lead, Boehringer Ingelheim.

A position paper authored by Timothy Kleinig and Lisa Murphy from the National Stroke Targets Taskforce emphasised the need for a unified commitment to stroke unit care and expedited reperfusion treatment.

“Clinicians, health administrators, and politicians need to commit to the key goals of stroke unit care for all, and expedited reperfusion treatment for eligible individuals,” they wrote.

To motivate change, national achievement and improvement awards will be introduced, alongside a national 30/60/90 stroke data dashboard. This dashboard, part of the national stroke registry, will allow hospitals and states to benchmark their performance against peers and national targets. Discussions are also underway to make the dashboard accessible to the public, empowering stroke survivors and their families to advocate for improved care.

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*National median endovascular clot retrieval door‐to‐puncture time < 30 minutes for transfers, National median thrombolysis door‐to‐needle time < 60 minutes, National median door‐in‐door‐out time for endovascular clot retrieval transfers < 60 minutes, National median endovascular clot retrieval door‐to‐puncture time < 90 minutes for primary presenters, Certified stroke unit care provided to > 90% of patients with primary stroke diagnosis