Centres of Research Excellence awarded to ANZSGM members

Frailty is prevalent in acute care settings, yet our hospitals are designed for younger, fitter patients with acute, single system problems. The vision of the Frailty ADD CRE is to improve hospital outcomes for patients who are frail. This CRE will evaluate frailty at scale, in hospitals, quantifying the prevalence of frailty and establishing frailty-related outcomes and frailty-related costs. We will investigate the relationship between frailty, medication utilisation and global health outcomes and partner with consumers to develop a core outcome set of patient-important outcomes that can be used for future research in any discipline.

The CRE will create an infrastructure of collaboration that would otherwise not be possible to achieve given the geographical spread and the multidisciplinary nature of the team. It unites four “nodes” where academic geriatricians have partnered with discipline experts to build clinical and research programs: pharmaco-epidemiology in Sydney (Sarah Hilmer and Danijela Gnjidic); anaesthesia in Melbourne (Kwang Lim and David Story); oncology in Perth (Chris Etherton-Beer and Anna Nowak) and psychiatry in Brisbane (me and Dan Siskind).

We have a strong focus on education and training and will be creating online learning platforms to increase health care professionals’ knowledge and understanding of frailty. Another key goal is to develop a new cohort of Early Career Academics with the methodological skills to design, implement and evaluate frailty-focused models of care. Emily Gordon and Heather Lane were integral to the programs of work outlined in our proposal and we have capacity for many others to become involved, providing start-up grants for ECAs from 2024.

Similar to Richard’s CRE, this program is the culmination of years of work and its success is a reflection of the calibre of the assembled team and the clarity of our shared vision. I undertook my Post Doctoral Fellowship (2007 – 2009) with Prof Rockwood and his inclusion as a Chief Investigator definitely went down well with reviewers. Sarah Hilmer has been my academic BFF and sounding board since we were Level Ds hitting the dance floor together at ANZSGM ASMs in the mid 2010s. I stepped out of research from 2016 – 2020 to become Head of a Clinical Unit for the UQ MD program and although that was not a strategic move at the time, leading a large team gave me the confidence to reach out to national and international colleagues to collaborate on this proposal.

The NHMRC Centre of Research Excellence to Accelerate Stroke Trial Innovation and Translation has been announced recently. This $2.5M five-year grant will support a national collaboration that includes 12 Universities and Medical Research Institutes based in 5 States. It’s a fantastic achievement to obtain this funding as we’ve been developing the ideas behind the application for over a decade, with development support from the Stroke Society of Australasia and the Stroke Foundation during the co-funded Australian Stroke Research Network pilot work. 

A Centre of Research Excellence to Accelerate Stroke Trial Innovation and Translation 
Chief Investigator Professor Richard Lindley

This Centre for Research Excellence will establish a whole-of-system approach to transform Australian stroke research capacity and implementation. By doing this we aim to achieve critical improvements to health services, thereby reducing the high burden of death and dependency from stroke. Our program of work will:

1. Generate a rich pipeline of randomised controlled trials to test new stroke interventions, each tailored to the best trial design as guided by our consumer co-design and trial methodology group.
2. Provide swift effective translation of this new knowledge into clinical practice with a ‘whole of system’ approach building on our links between academia, health services, non-government organisations (NGOs) and state and federal governments, by developing a national stroke learning health system.
3. Develop the stroke clinical trial health and medical research workforce to ensure that a new generation of clinical academics, regardless of where they are located, are identified, trained, supported and gain experience working on our CRE demonstration trials.

Our two cross cutting programs of (1) Consumer Co-Design and (2) Technology will ensure our CRE is directly addressing consumer needs, provides equitable access to trials and interventions regardless of location and is COVID-19 ‘safe’ during the current pandemic.

The team is very multidisciplinary, and being led by a geriatrician, will ensure the older person with stroke and frailty is not ignored. It’s certainly an exciting time for geriatric medicine for two CREs to be obtained by academic geriatricians and illustrates our strengths in clinical research that makes a difference.

For those wanting more information, or how they might become involved, please contact:
Professor Richard Lindley – Richard.lindley@sydney.edu.au or
Professor Ruth Hubbard – r.hubbard1@uq.edu.au

Image Courtesy Ruth Hubbard: Chief Investigator Prof. Ruth Hubbard and her team Frailty ADD: Improving Hospital Outcomes for Frail Patients Across Different Disciplines.