Major deficits in stroke care for Indigenous people are being addressed in WA programs that include cultural safety training and the use of Aboriginal Brain Injury Coordinators, neurologists say.
With a recent study showing substantial ongoing inequities in the diagnosis, management and follow up of stroke in Indigenous Australians, WA is trialling a “Healing Right Way” approach according to Dr David Blacker, consultant neurologist and stroke physician at Sir Charles Gairdner Hospital, Perth.
The new approach is needed in light of a study showing that Aboriginal Australians with ischaemic stroke are less likely to have basic investigations such as carotid and cardiac ultrasounds compared to non-Indigenous Australians, said Dr Blacker in an editorial co-authored with Professor Beth Armstrong PhD, a speech pathologist at Edith Cowan University, WA.
An investigation into stroke management for Indigenous Australians in a rural NSW setting also found that they were less likely to receive follow up (74.4% vs 87.4%) compared to non-Indigenous stroke patients.
The findings are of concern given that Indigenous people have a three fold higher risk of stroke and are on average 16 years younger than non‐indigenous subjects (56.8 vs 72.6 years old), notes Dr Blacker.
The high rates of stroke risk factors in Indigenous patients, including smoking (diabetes mellitus and past history of cerebrovascular accident or transient ischaemic attack “may indicate a failure of both primary and secondary prevention of stroke, with a particular focus on individuals with communication disorders,” according to Dr Blacker and Professor Armstrong
They say the Healing Right Way trial would provide Indigenous stroke survivors with a holistic health model that would require cultural security training for hospital staff involved in the care of patients following stroke and traumatic brain injuries.