The program under investigation targets patients who have had a transient ischemic attack (TIA). A TIA is a major warning sign for stroke; it is a short disruption in blood supply to the brain resulting in signs and symptoms similar to that of a stroke (eg. loss of speech, arm weakness etc). A TIA resolves in 24 hours but there is a 15% risk that the person will go on to have a stroke within the next 3 months, and the risk of having another cardiovascular event (eg. stroke, heart attack or TIA), remains high for the following 10-15 years.
The SLAM-TIA program involves 6 weeks of face to face education (30min) and exercise (60min) at a community based gym. Education sessions outline the signs and symptoms of a stroke, risk factors for and consequences of a stroke, and focus on individual stroke risk identification and goal setting. After this 6 weeks, patients are provided 12 weeks of fortnightly telehealth health coaching to support them to reduce their stroke risk by changing their health behaviours. Patients are given support and strategies to reduce individual stroke risk factors. Particular focus is given to increasing regular physical activity, reducing high blood pressure, improving diet (increasing fruit and vegetables and reducing salt), reducing psychological distress and adhering to guidelines on alcohol consumption.
Analysis of patient results collected in the pilot project which informed S+ SLAM-TIA reveals significant and clinically meaningful improvements in the leading risk factor for stroke, blood pressure. Patient systolic blood pressure reduced on average by 14mmg [95% CI 9-18] and a 8mmg [95%CI 4-12] reduction in diastolic blood pressure (p<0.001). Furthermore, patients had a 12% [95% CI 6-25] (p=0.02) improvement in quality of life, and reported that (i) they were highly satisfied with the program, (ii) “I can exercise” and (iii) “I am doing more exercise than what I was before the program”.
S+SLAM-TIA has to date recruited >30 patients, has employed two clinicians to work as research assistants (giving them the opportunity to actively engage in research for the first time), and is supported by NSW Health and HNE LHD through a Early to Mid-Career Fellowship and Honorary Clinical Research Fellowship for CI Janssen. Amount sought - $34 245.12"