The statistics around stroke in New Zealand make for grim reading, but Bala Nair, senior research programme manager from AUT’s National Institute for Stroke and Applied Neurosciences (NISAN), believes a stroke prevention tool developed by his team can change that.
Strokes are a leading cause of adult disability and the second leading cause of death, according to Stroke Aotearoa New Zealand. One in four New Zealanders will be affected by stroke in their lifetime – that’s around 350,000 people. Māori and Pacific people are generally 10-15 years younger when they have a stroke. The annual economic cost of stroke is over $1.1 billion – and rising. But Stroke Aotearoa says 90 per cent of strokes are preventable – and that’s where Nair and his team at NISAN are focusing their efforts.
“We’ve developed a web-based software application called PreventS-MD™ that starts with prevention by identifying risk factors, and which fits seamlessly into existing electronic patient management systems in outpatient clinics and hospitals,” says Nair.
“Stroke is a lifestyle problem, just like heart disease, respiratory disease, cancer, and diabetes. We know that one in two New Zealanders is at risk from these conditions and that we can prevent them. We know that people aren’t engaged in managing their lifestyle risks, clinical efforts are scattered, and services can be hard to access,” says Nair.
PreventS-MD™ runs in the background at each patient appointment, automatically pre-populating information on stroke risk factors to calculate an absolute and relative five-year risk assessment for stroke. It also generates patient-tailored recommendations for primary and secondary stroke prevention.
“Adopting a risk management approach such as this could help reduce the cost of stroke management. When you consider that each stroke patient requires around $300,000 in healthcare, we’re looking at an annual cost of $690 million, which is rising.”
Built on the award-winning Stroke Riskometer algorithm, PreventS-MD™ offers two tools – one for the health professional that is built into their management system, and one for the patient or community worker using the Stroke Riskometer mobile app on their smartphones and portable devices.
“Most strokes and cardiovascular diseases are potentially preventable if their risk factors are identified and well controlled. Digital platforms such as PreventS-MD™ can help healthcare professionals to assess and manage risk factors while promoting lifestyle changes for their patients,” says Nair.
“Seamless integration with existing electronic medical record systems will enable efficient data collection and analysis, personalised recommendations and real-time evaluations. The clinician can deliver evidence-based, preventive, and motivational counselling. This will lead to tangible savings in time and costs for clinicians, patients and the overall healthcare system.”
"This seamless integration enables us to predict potential health risks for patients using their existing medical records alongside the latest research. The software takes a unique approach by not only identifying health risks but also prioritising them. For example, if a patient is obese, smokes, and consumes alcohol, the system pinpoints the most critical factors requiring immediate intervention."
PreventS-MD™ will work on all platforms from a smartphone app to GPs’ software and a patient’s smartwatch. Its scalable solutions address disparities in healthcare accessibility across urban and rural settings and will include a range of languages from Māori, Samoan and Tongan to Hindi and Chinese.
“We’ve been testing PreventS-MD™ in hospitals across Northland, Auckland and Waikato, assessing how it fits into the workflow without adding new or more burden on the clinician, how the patient responds to the process and its efficacy in reducing new stroke events.
Nair says the team has two goals for the next 12 months. “The first goal is to connect with software providers, hospitals and public sector champions to work on adding PreventS-MD™ to their systems without causing extra burden. The second is to help users make changes that will benefit their health, such as adding 10 minutes’ walking morning and night, or cutting down on certain foods and eating more vegetables, and sticking to their medication. PreventS-MD™ has the potential to raise patient awareness, deliver an action plan and support the patient to make critical lifestyle changes.”
Over the next 3-5 years, Nair says they’ll be focusing on data collection and talking with healthcare providers, governments and organisations such as the World Health Organisation.
Ultimately, PreventS-MD Ltd aims to redefine how stroke and cardiovascular diseases are prevented and managed, delivering a lasting benefit to healthcare systems and patients on a global scale.
