Tactical training to revolutionize access to acute stroke treatment in regional Australia: results fromTACTICS Trial

TACTICS, a non-randomised intervention trial that aimed to optimsze workflow and implement specialized imaging, has shown promise in improving access to endovascular thrombectomy (EVT) for patients in regional and rural areas of Australia. EVT is a minimally invasive procedure that removes blood clots from blocked arteries in the brain, significantly improving outcomes for stroke patients.

“While EVT has revolutionized stroke treatment, access remains a challenge for patients outside major urban centers,” explains Dr. Delcourt, the investigator who presented the results of TACTICS today at the European Stroke Organisation Conference (ESOC) 2024. “The TACTICS trial investigated a multi-faceted intervention designed to address this disparity.”

The TACTICS trial involved six regional clusters in Australia, each with a central hub that is able to provide EVT and associated spoke hospitals. Each cluster underwent a three-month pre-intervention period followed by a three-month intervention, and a three-month post- intervention period. During the intervention, hospitals were exposed to a combination of face-to-face, video and virtual reality-based education. Additionally, the hospitals were fitted and trained to use multimodal brain imaging to optimise workflow and pathways, improve diagnosis and aid earlier detection of candidates for EVT.

The study enrolled 1,011 patients across the six clusters and a total of 34 hospitals. Compared to the pre-intervention period, the odds of receiving EVT in the pooled intervention and post-intervention period increased by 44%. Notably, these improvements were consistent across all participating clusters.

Dr Christopher Levi, lead investigator of TACTICS concludes: “These findings suggest that this intervention has the potential to be a valuable tool for healthcare systems worldwide, particularly those grappling with geographic barriers to stroke care.”

Further research is needed to confirm the long-term sustainability and generalizability of the TACTICS approach.

Reference:

TRIAL OF ADVANCED CT IMAGING AND COMBINED EDUCATION SUPPORT FOR DRIP AND SHIP(TACTICS): PRIMARY RESULTS. Presented at the European Stroke Organisation Conference; 15 May 2024; Basel, Switzerland.