ORCID Profile
0000-0002-4070-0533
Current Organisation
Monash University
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Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.SAPHARM.2022.01.007
Abstract: It is unclear whether survivors of stroke or transient ischemic attack (TIA) routinely receive, and understand, education about secondary prevention medications. To investigate whether survivors of stroke/TIA understand explanations about their prescribed prevention medications and associations with medication adherence, control of risk factors, and unmet needs. A survey was administered among survivors of stroke/TIA (random s le N = 1500) from the Australian Stroke Clinical Registry (Victoria and Queensland, 2016). Participants reported whether they understood explanations about each prescribed medication, as well as their unmet needs, perceived control of risk factors, and 30-day medication adherence. Linked pharmacy claims data were also used to determine medication adherence in the previous two years (proportion of days covered ≥80%). Outcomes were analyzed using multivariable logistic regression or multivariable negative binomial regression for frequency of unmet needs. Overall, 630/1455 eligible survivors completed the survey at ≈2.5 years post-admission (median age 69 years 37% female). Most participants reported using prevention medications (76% antihypertensive 84% antithrombotic 76% lipid-lowering) but only 66-75% reported they understood explanations about their medication (75% antihypertensive 66% antithrombotic 74% lipid-lowering). Participants who understood explanations about their medication more often reported 30-day adherence for antihypertensive (adjusted odds ratios [aOR]: 1.96 95% CI: 1.20-3.19), antithrombotic (aOR: 2.03 95% CI: 1.31-3.14) and lipid-lowering medications (aOR: 1.73 95% CI: 1.08-2.76). Similar associations were observed for antihypertensive and antithrombotic medications when pharmacy claims data were used to infer 2-year medication adherence. Understanding explanations about medications was also associated with perceived control of risk factors (hypertension: aOR: 11.08 95% CI: 6.04-20.34 cholesterol aOR: 8.26 95% CI: 4.72-14.47) and up to 33% fewer unmet needs related to secondary prevention. Expanded efforts are needed to improve the delivery of information about prevention medications to promote medication adherence, control of risk factors, and potentially prevent unmet needs following stroke/TIA.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2023
DOI: 10.1161/STROKEAHA.122.041355
Abstract: Untreated poststroke mood problems may influence long-term outcomes. We aimed to investigate factors associated with receiving mental health treatment following stroke and impacts on long-term outcomes. Observational cohort study derived from the Australian Stroke Clinical Registry (AuSCR Queensland and Victorian registrants: 2012–2016) linked with hospital, primary care billing and pharmaceutical dispensing claims data. Data from registrants who completed the AuSCR 3 to 6 month follow-up survey containing a question on anxiety/depression were analyzed. We assessed exposures at 6 to 18 months and outcomes at 18 to 30 months. Factors associated with receiving treatment were determined using staged multivariable multilevel logistic regression models. Cox proportional hazards regression models were used to assess the impact of treatment on outcomes. Among 7214 eligible in iduals, 39% reported anxiety/depression at 3 to 6 months following stroke. Of these, 54% received treatment (88% antidepressant medication). Notable factors associated with any mental health treatment receipt included prestroke psychological support (odds ratio [OR], 1.80 [95% CI, 1.37–2.38]) or medication (OR, 17.58 [95% CI, 15.05–20.55]), self-reported anxiety/depression (OR, 2.55 [95% CI, 2.24–2.90]), younger age (OR, 0.98 [95% CI, 0.97–0.98]), and being female (OR, 1.30 [95% CI, 1.13–1.48]). Those who required interpreter services (OR, 0.49 [95% CI, 0.25–0.95]) used a health benefits card (OR, 0.73 [95% CI, 0.59–0.92]) or had continuity of primary care visits (ie, with a consistent physician OR, 0.78 [95% CI, 0.62–0.99]) were less likely to access mental health services. Among those who reported anxiety/depression, those who received mental health treatment had an increased risk of presenting to hospital (hazard ratio, 1.06 [95% CI, 1.01–1.11]) but no difference in survival (hazard ratio, 0.86 [95% CI, 0.58–1.27]). Nearly half of the people living with mood problems following stroke did not receive mental health treatment. We have highlighted subgroups who may benefit from targeted mood screening and factors that may improve treatment access.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2023
Publisher: SAGE Publications
Date: 15-11-2022
DOI: 10.1177/18333583221124371
Abstract: Administrative data are used extensively for research purposes, but there remains limited information on the quality of these data for identifying comorbidities related to stroke. To compare the prevalence of comorbidities of stroke identified using International Classification Diseases, Australian Modification (ICD-10-AM) or Anatomical Therapeutic Chemical codes, with those from (i) self-reported data and (ii) published studies. The cohort included patients with stroke or transient ischaemic attack admitted to hospitals (2012–2016 Victoria and Queensland) in the Australian Stroke Clinical Registry (N = 26,111). Data were linked with hospital and pharmaceutical datasets to ascertain comorbidities using published algorithms. The sensitivity, specificity, and positive predictive value of these comorbidities were compared with survey responses from 623 patients (reference standard). An indirect comparison was also performed with clinical data from published stroke studies. The sensitivity of hospital ICD-10-AM data was poor for most comorbidities, except for diabetes (93.0%). Specificity was excellent for all comorbidities (87–96%), except for hypertension (70.5%). Compared to published stroke studies (3 clinical trials and 1 incidence study), the prevalence of diabetes and atrial fibrillation in our cohort was similar using ICD-10-AM codes, but lower for dyslipidaemia and anxiety/depression. Whereas in the pharmaceutical dispensing data, the sensitivity was excellent for dyslipidaemia (94%) and modest for anxiety/depression (77%). In the pharmaceutical data, specificity was modest for hypertension (78%) and anxiety or depression (76%), but specificity was poor for dyslipidaemia (19%) and heart disease (46%). Variation was observed in the reporting of comorbidities of stroke in administrative data, and consideration of multiple sources of data may be necessary for research. Further work is needed to improve coding and clinical documentation for reporting of comorbidities in administrative data.
Publisher: Cold Spring Harbor Laboratory
Date: 06-09-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2022
DOI: 10.1161/STROKEAHA.122.038829
Abstract: Evidence is growing on anticancer effects of statins. We investigated whether the effectiveness of treatment with statins after ischemic stroke on mortality is influenced by a history of cancer. Analyses of 90-day survivors of ischemic stroke (2012–2016 45 hospitals) using linked registry and administrative data. Dispense of statins within 90 days postdischarge was determined from pharmaceutical records. Participants were followed from 91 days postdischarge until death or June 30, 2018. History of cancer was determined from hospital data. Propensity score–adjusted Cox proportional hazards regression model was used to determine the association between being dispensed statins and survival. The influence of history of cancer on this association was assessed based on the concepts of (1) statistical interaction and (2) biological interaction using 3 indices: relative excess risk due to interaction , attributable proportion due to interaction , or synergy index . Among 9948 eligible participants (median age=72 years, 42% female), there were 1463 deaths. In adjusted analyses, there was no statistical interaction between being dispensed statins and history of cancer on mortality ( P =0.156). However, being dispensed statins had a significant positive biological interaction with having a history of cancer on mortality: relative excess risk due to interaction, 2.80 (95% CI, 1.56–5.05), attributable proportion due to interaction, 0.45 (95% CI, 0.23–0.66), and synergy index, 2.14 (95% CI, 1.32–3.49). Treatment with statins after ischemic stroke may confer additional survival benefits for people who also have had cancer.
Publisher: Springer Science and Business Media LLC
Date: 18-05-2020
Publisher: Elsevier BV
Date: 05-2019
Publisher: Elsevier BV
Date: 04-2020
Publisher: Springer Science and Business Media LLC
Date: 03-2022
DOI: 10.1007/S11910-022-01180-Z
Abstract: To critically appraise literature on recent advances and methods using “big data” to evaluate stroke outcomes and associated factors. Recent big data studies provided new evidence on the incidence of stroke outcomes, and important emerging predictors of these outcomes. Main highlights included the identification of COVID-19 infection and exposure to a low-dose particulate matter as emerging predictors of mortality post-stroke. Demographic (age, sex) and geographical (rural vs. urban) disparities in outcomes were also identified. There was a surge in methodological (e.g., machine learning and validation) studies aimed at maximizing the efficiency of big data for improving the prediction of stroke outcomes. However, considerable delays remain between data generation and publication. Big data are driving rapid innovations in research of stroke outcomes, generating novel evidence for bridging practice gaps. Opportunity exists to harness big data to drive real-time improvements in stroke outcomes.
Publisher: Wiley
Date: 10-05-2017
DOI: 10.1111/ENE.13306
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2023
DOI: 10.1161/HYPERTENSIONAHA.122.19883
Abstract: Real-world evidence is limited on whether antihypertensive medications help avert major adverse cardiovascular events (MACE) after stroke without increasing the risk of falls. We investigated the association of adherence to antihypertensive medications on the incidence of MACE and falls requiring hospitalization after stroke. A retrospective cohort study of adults who were newly dispensed antihypertensive medications after an acute stroke (Australian Stroke Clinical Registry 2012–2016 Queensland and Victoria). Pharmaceutical dispensing records were used to determine medication adherence according to the proportion of days covered in the first 6 months poststroke. Outcomes between 6 and 18 months postdischarge included: (i) MACE, a composite outcome of all-cause death, recurrent stroke or acute coronary syndrome and (ii) falls requiring hospitalization. Estimates were derived using Cox models, adjusted for confounders using inverse probability treatment weights. Among 4076 eligible participants (median age 68 years 37% women), 55% had a proportion of days covered ≥80% within 6 months postdischarge. In the subsequent 12 months, 360 (9%) participants experienced a MACE and 337 (8%) experienced a fall requiring hospitalization. After achieving balance between groups, participants with a proportion of days covered ≥80% had a reduced risk of MACE (hazard ratio: 0.68 95% CI: 0.54–0.84) and falls requiring hospitalization (subdistribution hazard ratio: 0.78 95% CI: 0.62–0.98) than those with a proportion of days covered %. High adherence to antihypertensive medications within 6 months poststroke was associated with reduced risks of both MACE and falls requiring hospitalization. Patients should be encouraged to adhere to their antihypertensive medications to maximize poststroke outcomes.
Publisher: SAGE Publications
Date: 18-10-2023
Publisher: SAGE Publications
Date: 07-07-2023
DOI: 10.1177/18333583231184004
Abstract: Accurate coded diagnostic data are important for epidemiological research of stroke. To develop, implement and evaluate an online education program for improving clinical coding of stroke. The Australia and New Zealand Stroke Coding Working Group co-developed an education program comprising eight modules: rationale for coding of stroke understanding stroke management of stroke national coding standards coding trees good clinical documentation coding practices and scenarios. Clinical coders and health information managers participated in the 90-minute education program. Pre- and post-education surveys were administered to assess knowledge of stroke and coding, and to obtain feedback. Descriptive analyses were used for quantitative data, inductive thematic analysis for open-text responses, with all results triangulated. Of 615 participants, 404 (66%) completed both pre- and post-education assessments. Respondents had improved knowledge for 9/12 questions ( p 0.05), including knowledge of applicable coding standards, coding of intracerebral haemorrhage and the actions to take when coding stroke (all p 0.001). Majority of respondents agreed that information was pitched at an appropriate level education materials were well organised presenters had adequate knowledge and that they would recommend the session to colleagues. In qualitative evaluations, the education program was beneficial for newly trained clinical coders, or as a knowledge refresher, and respondents valued clinical information from a stroke neurologist. Our education program was associated with increased knowledge for clinical coding of stroke. To continue to address the quality of coded stroke data through improved stroke documentation, the next stage will be to adapt the educational program for clinicians.
No related grants have been discovered for Muideen Olaiya.