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Health News

Low dose aspirin won’t help some older adults trying to avoid a stroke: study

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Low dose aspirin won’t help some older adults trying to avoid a stroke: study 

 

Monash University 

A Monash University-led study has found that the risk of brain bleeding outweighs any potential benefit of reducing the risk of strokes in healthy older adults who take daily low dose aspirin.

Published in JAMA Network Open, this is the first major investigation into the risk/benefit of aspirin as a primary prevention measure in older people, who are often exposed to head trauma through falls and other knocks to the head. Bleeding is a known side effect of aspirin.

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Researchers drew on data from ASPREE (ASPirin in Reducing Events in the Elderly), a primary prevention aspirin trial involving more than 19,000 initially healthy older adults, mostly over the age of 70, the vast majority in Australia and the rest in the USA.

Primary prevention involves actions to preserve health and prevent adverse health events. Secondary prevention interventions are taken after a health event to avoid it happening again.

The participants, who did not have known cardiovascular disease when they entered the study, were randomly assigned 100 mg daily aspirin or placebo tablet for an average of five years.

The secondary analysis study found no statistically significant difference in the incidence of ischemic stroke – the most common type of stroke, caused by a blockage in vessels carrying blood to the brain – between the aspirin and placebo group.

Overall, strokes were reported in 4.6 per cent of the aspirin group and 4.7 per cent in the placebo group. While the number of brain bleeds was small, bleeding events were 38 per cent higher in those who took aspirin compared to placebo.

A older adult taking aspirin

the risk of brain bleeding outweighs any potential benefit of reducing the risk of strokes in healthy older adults who take daily low dose aspirin.

The researchers concluded that the risk of brain bleeding outweighed any potential benefit in reducing strokes. This included bleeds into the brain, and bleeds on the brain surface which are commonly associated with head trauma.

“These findings suggest that low-dose aspirin may have no role for the primary prevention of stroke and that caution should be taken with use of aspirin in older persons prone to head trauma e.g. from falls,” the researchers wrote.

Senior Author Professor John McNeil said the study underlined possible risks for some, but older people taking aspirin should not stop doing so without consulting with their GP.

“Although the overall incidence of bleeding was not common, it highlighted another risk of low-dose aspirin, especially relevant to older people susceptible to head trauma,” Professor McNeil said.

“These findings do not apply to older adults taking aspirin on medical advice, such as after a heart attack and ischaemic stroke. In secondary prevention, the balance of risks and benefits generally favours aspirin. It’s important to consult with your GP before making any changes to your medicine intake.”

First author and Director of Stroke Services at Alfred Health, Professor Geoffrey Cloud, said people could reduce their risk of stroke by living a healthy lifestyle.

“Older people concerned about reducing their risk of having their first stroke should not take daily aspirin without their doctor’s advice but instead concentrate on modification of lifestyle risk factors and blood pressure control,” he said.

 

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Budget 2024-25: Rural Health Equity Remains Unaddressed

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Budget 2024-25: Rural Health Equity Remains Unaddressed

 

Statement by the National Rural Health Alliance

The recent Federal Budget has missed a crucial opportunity to tackle the persistent healthcare disparities between rural and urban Australia, asserts the National Rural Health Alliance.

Nicole O’Reilly, Chairperson of the National Rural Health Alliance, expressed disappointment at the budget’s failure to meet expectations. She emphasised the government’s lack of responsiveness to rural voices and its failure to commit to comprehensive reforms that would deliver sustainable and long-term benefits for rural communities.

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The statistics paint a stark picture: Australians living farther from urban centres have lower life expectancies and are twice as likely to succumb to preventable illnesses. Rural men and women face significantly higher risks of dying from avoidable causes compared to their urban counterparts. Alarmingly, many rural residents lack access to primary healthcare services within a reasonable distance from their homes, leading to reduced utilisation of Medicare services and exacerbating the burden of disease in remote areas.

O’Reilly highlighted the evidence indicating a significant disparity in healthcare spending, with each person in rural and remote Australia missing out on nearly $850 per year in healthcare access, totalling an annual rural health underspend of $6.5 billion.

The National Rural Health Alliance welcomed certain budget measures, such as the support for rural training opportunities through initiatives like the Charles Darwin University Menzies Medical Program and additional funding for the Royal Flying Doctors Service. However, O’Reilly stressed that these efforts alone are insufficient to address the diverse healthcare needs across rural and remote Australia.

While acknowledging positive steps, O’Reilly emphasised the urgent need for more comprehensive and sustained commitments to ensure equitable healthcare outcomes for rural and remote Australians. She urged the government to prioritise rural health reform in future budget allocations to ensure that all communities receive the care and support they deserve.

 

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Health News

New research partnership to tackle hearing loss

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New research partnership to tackle hearing loss

 

An exciting new collaboration has been established between the Ear Science Institute Australia and the National Acoustic Laboratories (NAL), uniting Australia’s leading hearing researchers in a concerted effort to enhance treatments for the millions affected by hearing impairments.

National Acoustics Laboratories Director, Brent Edwards, emphasised the significance of the collaboration, stating, “This partnership harnesses the collective expertise of some of Australia’s most dedicated and forward-thinking hearing researchers, all committed to profoundly improving hearing healthcare globally.”

Hearing loss is among the world’s most prevalent health issues, with projections suggesting that by 2050 nearly 2.5 billion individuals will experience some form of hearing impairment. This partnership aims to foster substantial advancements in the quality of life for those affected by hearing loss, both in Australia and worldwide.

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By pooling their vast resources and data, both institutions are poised to transform hearing health care. The Ear Science Institute Australia, recognised globally as a for-purpose center of excellence, combines scientific research, medical innovation, and clinical practice to pioneer new treatments for ear and hearing conditions, ultimately striving to discover a cure for hearing loss.

Ear Science Institute’s CEO, Sandra Bellekom, commented on the future implications of the partnership, “Looking forward, this alliance with National Acoustic Laboratories opens new pathways for sharing knowledge, which will enhance the delivery of cutting-edge, personalised hearing solutions and expand access to superior hearing care for people around the world.”

 

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Introduction of New Clinical Care Standard by ACSQHC to Address Psychotropic Medicine Use in Cognitive Disability and Impairment

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Introduction of New Clinical Care Standard by ACSQHC to Address Psychotropic Medicine Use in Cognitive Disability and Impairment

 

By Jeff Gibbs

The Australian Commission on Safety and Quality in Health Care (the Commission) has today announced the launch of a pivotal new national standard aimed at enhancing the care for individuals with cognitive disabilities or impairments. The introduction of the Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard is a critical advancement in promoting safer and more effective treatment protocols across the healthcare spectrum.

Background and Rationale for the New Standard

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Recent decades have witnessed a 60% surge in the prescription of psychotropic medications across Australia. Despite a modest reduction in antipsychotic use among the elderly—prompted by heightened awareness of associated risks—the prescribing rates remain alarmingly high, particularly among vulnerable populations. Notably, older individuals and those residing in aged care facilities are disproportionately affected by the adverse effects of these medications, including cognitive decline, heightened risk of falls, strokes, and mortality. Additionally, approximately one-third of individuals with intellectual disabilities are prescribed psychotropic drugs, exposing them to potentially severe short and long-term side effects.

Scope and Impact of the Standard

The new Standard seeks to mitigate the inappropriate utilisation of psychotropic medications and emphasises patient safety. It priorities non-pharmacological interventions as the foremost approach for managing challenging behaviours such as aggression and agitation. Psychotropic medications are advised as a last-resort measure, following the ineffectiveness of alternative strategies or in situations posing significant risk to the individual or others.

The Standard advocates for tailored non-medication strategies that respect the individual’s needs and preferences, developed in consultation with their family and other authorised caregivers. This approach underscores the commitment to upholding the dignity and autonomy of individuals with cognitive impairments.

Expert Insights and Support

Key health experts have endorsed the significance of this new Standard. Conjoint Associate Professor Carolyn Hullick, Chief Medical Officer at the Commission, stresses the necessity for mindful prescribing practices given the limited benefits and substantial risks associated with psychotropic medications in this demographic. Professor Julian Trollor from the University of New South Wales and Juanita Breen from the University of Tasmania also highlight the importance of objective-driven prescribing, continuous monitoring, and the potential to reduce medication dosages in favour of non-pharmacological alternatives.

Implementation Across Settings

The Standard is applicable universally across various healthcare settings, including hospitals, aged care facilities, and community services, ensuring that individuals with cognitive disabilities receive consistent and coordinated care irrespective of the setting.

Professor Eddy Strivens emphasises the need for coordinated efforts and effective communication, particularly during care transitions, to maintain continuity and efficacy of treatment plans and to support decision-making processes that honour patient autonomy.

Collaborative Efforts for Enhanced Care

In a collective endeavour to address these issues, the Commission has collaborated with the Aged Care Quality and Safety Commission and the NDIS Quality and Safeguards Commission to issue a Joint Statement against the misuse of psychotropics in managing behaviours in disabled and elderly populations.

Conclusion

The introduction of the Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard marks a significant step forward in improving the quality of care and safety for Australians with cognitive disabilities or impairments. It aligns with ongoing efforts to reform health care, aged care, and disability support systems across the nation.

The complete Standard and accompanying resources are available on the Commission’s website here.

 

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