Home' Australian Pharmacist : Australian Pharmacist August 2013 Contents 16 Australian Pharmacist August 2013 I ©Pharmaceutical Society of Australia Ltd.
More strokes but fewer deaths
The ageing of Australian's population has
led to an increase in the number of people
having strokes even though the number of
deaths from stroke has dropped.
According to the Australian Institute of
Health and Welfare (AIHW) report, Stroke
and its management in Australia: an update,
stroke death rates in Australia fell by 70%
between 1979 and 2010. It shows there
were 8,300 deaths from stroke in 2010 --
representing 6% of all deaths, or about
23 deaths a day.
However, while death rates have fallen,
the total number of strokes rose by about
6% over the same period -- largely due to
population ageing -- most strokes occur in
older people (aged 65 and over).
Responding to the
from the University
of Tasmania School
of Pharmacy and
Aged care columnist,
said that pharmacists could contribute in
several important ways to stroke prevention
'They can help improve stroke awareness
amongst their clientele and community, so
that individuals having a stroke are more
likely to promptly present to hospitals
and their specialised stroke units for rapid
assessment and initiation of therapy,
including thrombolysis, which has
contributed to the improved outcomes for
'In addition, they can contribute to the
optimum management of major risk factors
for stroke, including hypertension and
atrial fibrillation, to ensure patients are well
controlled, adherent with medications,
and receiving evidence-based therapies --
for instance, appropriate antithrombotic
therapy in chronic atrial fibrillation,'
Professor Peterson said.
AIHW spokesperson Ann Hunt said that
despite the higher total number of strokes,
the rates of stroke across the population
fell by an estimated 25% between
1997 and 2009. There were more than
35,300 hospitalisations for stroke and
25,800 hospitalisations for rehabilitation
care associated with stroke in 2009-10.
'The good news is that more people are
surviving a stroke than previously, and
disability caused by stroke has fallen, from
45% of cases to 35%,' Ms Hunt said.
Specialised care facilities, or stroke units,
have been shown to significantly improve
health outcomes for stroke patients, and
the number of these facilities has increased.
'There is evidence to suggest that patients
admitted to stroke units have better
outcomes than other patients, so it is
particularly important that patients are
admitted to these units where possible,' Ms
Between 2007 and 2011, the number of
stroke units in public hospitals rose from
54 to 74 and the proportion of patients
receiving stroke unit care rose from
50% to 60%.
'Currently, 39% of those hospitals required
to admit and manage people with acute
stroke have a specialised stroke unit. While
this proportion has risen in recent years, it is
still low compared to other countries with
similar economies to Australia's.'
Informal carers also play an important role
in the care and recovery of stroke survivors,
with an estimated 75,000 providing
assistance to people with stroke and
disability in 2009.
'More than half of these informal carers
spend 40 hours or more each week in their
caring role,' Ms Hunt said.
Long term view needed
Ensuring Australians have access to new
medicines in the future and growing the
Australian medicines industry will require
more long term thinking and collaboration,
Medicines Australia (MA) has told a
Speaking at the CEDA 2013 Health Forum
on 28 June, MA Chief Executive Dr Brendan
Shaw warned that a short term focus in
health could jeopardise future generations'
access to new medicines and vaccines.
'One of the issues we face in the future is the
collision between the range of new medical
technologies, the ageing population and
our unwillingness or inability to pay for this,'
Dr Shaw said.
the range of new
therapies in the
pipeline, the ageing
is like watching a
40 year train wreck happen in slow motion
-- and we are not talking about it sensibly.
'I am really concerned that in the austerity
drive we're seeing around the world
governments will forsake long term
incentives for developing new medicines
in favour of short term cost cutting.
If governments cut back too hard on
spending on new medicines, or put too
many restrictions on their use, they send
a signal to the medicines industry not to
invest in developing new therapies,' he said.
'We have an Australian medicines industry
that is already one of Australia's leading
manufacturing industries with some
great examples of Australian-owned
and international companies building
commercial success here. But we can do so
much more. Reports like the McKeon review
of health and medical research provide a
roadmap for what we need to do'.
Bowel cancer screening
Although evidence shows bowel cancer
screening saves lives, Australians were
less likely to take up their invitation to
screen in the Australian Government's
free National Bowel Cancer Screening
Program (NBCSP) in 2011--12 compared
with the previous three years, according
to the Australian Institute of Health and
Welfare (AIHW) National Bowel Cancer
Screening Program: July 2011-- June 2012
monitoring report. It presents statistics
on the National Bowel Cancer Screening
Program for Australians invited to take
part between July 2011 and June 2012.
Just over 320,000 people were screened
in that time, with about 22,500 found to
require further assessment. One out of
every 15 assessments recorded detected
an advanced adenoma (pre-cancerous
lesion), and a bowel cancer was detected
in one out of every 32 assessments.
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