Home Lottery at the heart of South Australia

EACH year, thousands of people have their lives changed by simply buying a ticket. Be it through winning a prize or benefiting from the money raised, this is a chance for all South Australians to be winners in 2018’s $2.9 million dollar first prize. 

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EACH year, thousands of people have their lives changed by simply buying a ticket. Be it through winning a prize or benefiting from the money raised, this is a chance for all South Australians to be winners in 2018’s $2.9 million dollar first prize.

 

Three research projects funded by The Hospital Research Foundation’s (THRF) Hospital Research Home Lottery are at the heart of South Australia’s health. Spread across the state’s three largest hospitals, the Royal Adelaide, the Lyell McEwin and The Queen Elizabeth, clinicians are investigating links to heart disease and running new trials in the fight against this potentially killer condition.

At the Royal Adelaide Hospital, Professor Prashanthan Sanders and Dr Jeroen Hendriks from the Centre for Heart Rhythm Disorders and University of Adelaide are researching atrial fibrillation (AF), the most common heartbeat disorder that causes light-headedness, a racing heart and even blood clots, heart failure or stroke.

In 2010, 33.5 million patients worldwide were affected by AF, responsible for a third of all strokes. In Australia, hospital admissions for AF are increasing at an exponential rate, putting pressure on an already overloaded health care system. The problem, says Prof Sanders, is that there is no consistency of treatment for patients: so what one receives at one hospital can differ vastly for another patient at a second hospital.

This inconsistency, he says, can result in poorer outcomes for patients, with complications and under-treatment leading to more problems and more hospital visits.

“There is no standard of care despite the fact there is guideline evidence on how we can improve outcomes for people with atrial fibrillation,” Prof Sanders says. “What we’re trying to do is to put together a package we hope is going to become the standard, not just in Adelaide but across the world, that this is how delivery of service needs to be in order to achieve the best outcomes for our patients.”

To this end, Prof Sanders and Dr Hendriks implemented (i-CARE), a specialised integrated care clinic that uses a multi-disciplinary approach to treat AF, bringing together specialists, nurses and allied professionals to deliver the best outcome for patients. The team is assisted by a software program that can be used by both patient and clinical staff to monitor risk factors for AF such as diet, blood pressure and weight management.

“For the patient it can work as an educational tool and for the team it can help in decision making,” Dr Hendriks says. “We can also communicate with the patient through the software and see what is happening: for example, a diet isn’t going well so now is the time to call the patient and say, ‘We need to catch up in the office and see what we can improve’. That’s how we want to work with the patient.”

And the results have been impressive.

“Our data says we can get rid of atrial fibrillation in 40 per cent of cases if we can manage their risk factors,” Prof Sanders says. “If you can imagine that means 40 per cent of the big burden that comes to hospital, we no longer need to see in hospital, that’s what we need. So we think this is really going to have a big impact.”

Both Sanders and Hendriks acknowledge the support of the THRF, which provided the funding to carry out their research.

“It’s fantastic we have THRF associated with our hospital because we now have a funding source for these kind of innovative ideas,” Prof Sanders says. “Without funding and the ability to make such apps and have resources where we can deliver this kind of thing, we’re never going to be able to advance and improve health care.” Over at the Lyell McEwin Hospital, Emily Aldridge is another recent recipient of funding from THRF. The University of Adelaide Medical School PhD candidate is studying the link between pregnancy complications and cardiovascular disease in later life – crucial research given that heart disease is classed as the No.1 killer of women not just in Australia but across the globe.

“Women who have things like high blood pressure and diabetes during their pregnancy have an increased risk of having heart disease in the future, which means things like heart attacks and heart failure,” Aldridge says. “We’re seeing them early after their pregnancy to try to help them reduce their risks, so hopefully we don’t see them in hospital having a serious event in 10 years’ time.”

Working towards risk reduction, the research team led by Associate Professor Margaret Arstall has established the COFFEE (Cardiovascular assessment after Obstetric complications: Follow-up For Education and Evaluation) clinic at the LMH, at which women who have experienced pregnancy complications such as gestational hypertension, pre-eclampsia, eclampsia, HELLP and gestational diabetes can receive advice on lifestyle changes and risk reduction, as well as referrals to relevant specialists.

“The national average is one in four women develop complications during pregnancy, which is a very significant number, but a lot of women don’t even know they’ve had a complication, never mind knowing about the link between heart disease and pregnancy complications,” Aldridge says. “People are definitely surprised – there’s still even a lot of clinicians who don’t have any idea about the link. So we’re trying to make this information common knowledge, that if you do have this you can do something about it early.”

New mum Ellen Schier admits she was shocked to discover she had pregnancy diabetes at 28 weeks’ gestation – despite doing everything right for the health of her baby.

“I had no risk factors, no family history, no reason to have had diabetes,” she says. “I had only put on about 6kg at the time so I wasn’t expecting the diagnosis.”

Taking advantage of all the information on offer, Schier stuck to a strict diet for the remainder of her pregnancy and successfully avoided having to take medicine to control her blood sugar levels, which quickly returned to normal levels after the birth of her son, Leon.

But Schier, 28, is aware she isn’t completely out of the woods.

“It’s not very nice to think you try to do everything right and then you get this complication during pregnancy that increases your risk of getting diabetes in the future by 50 per cent, and on top of that to know you’re at risk of heart problems regardless of your health background,” she says. “There’s nothing I could do to stop having pregnancy diabetes and now I’m at risk.”For Schier, the COFFEE clinic is a valuable tool to maintaining her future health.

“Having the clinic to remind me every year – ‘What have you been doing, are you getting the test redone, how’s everything going, are you eating right, are you checking all your health properly?’ – I think that’s really important and it’s good, especially for mums, because we do go on the back burner a bit.”

Women’s health and heart issues are also a concern for Professor John Beltrame, a leading cardiologist and academic researcher as well as Director of Research at the Central Adelaide Local Health Network.

The professor has received funding through the Hospital Research Home Lottery for a number of research projects, his most recent being an investigation into Syndrome X, a coronary microvascular disorder that most commonly affects women. Manifesting itself as chest pain during periods of activity, the syndrome causes confusion in diagnosis as it produces positive exercise but normal angiogram test results.

This confusion, says Prof Beltrame, has in the past led to women’s complaints of chest pain being discounted or even ignored.

“With someone who has chest pain coming from the heart and an exercise test that looks abnormal, you’d expect to find blockages in the arteries that are usually cholesterol related,” he says. “What’s tended to happen in the past is that, well, obviously the pain’s not coming from the heart; it’s a false positive exercise test because the angiogram’s normal. Whereas the actual answer we’ve learnt over the years is that these women have problems with the microscopic blood vessels rather than the big arteries, which the angiogram only looks at. “Patients, particularly in the past, haven’t been recognised as having a problem – implying it’s all in their head, basically, because the angiogram is normal. The problem is we’re trying to deal with a condition we can’t actually see on the angiogram.”

Prof Beltrame has been carrying out a number of different research studies with microscopic blood vessels looking at treatment options. The tricky thing for him and his team is that there is no one common treatment for all patients.

“We need more research because what’s clear is that they all haven’t got the same condition and you need to be able to distinguish them better,” he says. “My personal goal is to find something to improve the quality of life of these people I keep seeing, a number of them who keeps getting disabling pain. You just think, if only we could find the right drug to open up those microscopic blood vessels then we will help their chest pain and improve their quality of life.”

And it’s thanks to THRF and its Hospital Research Home Lottery that clinicians and researchers such as Prof Sanders and Dr Hendriks, Emily Aldridge and Prof Beltrame can continue to improve the lives and health of all South Australians. Since the lottery began, THRF has donated more than $94 million in grants to research and patient care activities in South Australian hospitals, funding more than 40 different areas including cardiology, cancer, stroke and kidney disease.

“The Hospital Research Home Lottery makes a significant impact in the lives of South Australians, providing funds to those in the community who need it most,” THRF chief executive Paul Flynn says.

“This current lottery will enable us to provide even more research and patient care grants this year into local hospitals including The Queen Elizabeth Hospital, the Royal Adelaide Hospital and the Lyell McEwin Hospital.”

Participants in this year’s lottery can win a fully furnished Scott Salisbury home in the seaside suburb of Brighton, overlooking the esplanade with unspoilt views of the ocean. The winner will also take home $1 million in cash.

This year there are more than 19,500 prizes to be won, including an Early Bird Prize valued at $500,000 along with six Mercedes-Benz GLC 250 wagons, holidays to Tahiti, New Zealand and Fiji, an Apple Macbook Pro, Monarto Zoo family safari, The Best of Adelaide “Mad March” Experience and more, with money raised from the Hospital Research Home Lottery helping to fund research projects across South Australia.

Order your tickets today. Go to the lottery website.  

Originally published as Home Lottery at the heart of South Australia