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Busload of medical help for vulnerable Tasmanians

A collaboration of medical organisations is continuing to deliver research to improve the lives of some of our most vulnerable Tasmanians during the pandemic.

The study called RiskHELP, a joint initiative between the University of Tasmania’s Menzies Institute for Medical Research and the Baker Heart and Diabetes Institute, is using a ‘Biobus’ to reach people who would not currently be able to access the medical care the research provides.

The Biobus is a mobile clinic and laboratory that has been fitted out to provide remote access to clinical research. RiskHELP is focused on a risk-guided home management strategy for heart failure, one of the most costly diagnoses in the Australian health system. Its aim is to keep people from being readmitted to hospital and helps them to manage their health at home.

Research Nurse and study coordinator Kristyn Whitmore has been taking the Biobus to Bridgewater, Oatlands, Rokeby and Central Hobart to visit study participants who have been assessed as having a high risk of readmission to hospital within 30 days.

“This has been an excellent way to ensure early access to diagnosis and treatment. The patients feel safe in the bus, and I am able to quickly use the handheld ultrasound equipment and then work with cardiologists to diagnose and treat the conditions.”

“We ensure the bus is cleaned between each participant, with all surfaces treated with Viraclean. We wear masks and gowns if required, and the patient is also required to wear a mask and have their temperature taken. Prior to visiting the patient a COVID-19 screening questionnaire is done to review their risk.”

Patients are usually over 70 and have been experiencing high levels of isolation during the COVID-19 pandemic.

“There’s a level of excitement when I turn up in the Biobus. This study has also had other positives – some of the people were confused with the information regarding the government’s lockdown rules and didn’t realise they could safely walk in their backyards or go to the letterbox,” Ms Whitmore said.

It has also given people the confidence to access other health services such as the flu vaccine.

Director of the Baker Heart and Diabetes Institute Professor Tom Marwick is the principal investigator of the study, funded by a Medical Research Future Fund ‘Keeping Australians Out of Hospital’ grant. The national research project aims to tackle the huge annual costs for heart failure readmissions, which exceed $1 billion.

“About 30,000 Australians suffer heart failure each year, and 20 to 25 per cent of these patients are admitted back to hospital within 30 days of being discharged. This is expensive, uses beds and resources, and patients do not want to be there,” Professor Marwick said.

“While the pandemic has meant we’ve needed to get creative in how we deliver our new intervention in the community, it’s also highlighted the project’s importance.

“People with heart disease – including those at risk of heart failure – are more likely to experience complications from COVID-19. We need to keep these patients away from the risk of infection as much as possible, and part of that is about reducing their chance of having to go to hospital.

“It’s important we don’t forget about cardiovascular disease during the pandemic, it’s still the number one killer in Australia, and it’s not going away.”

The Director of the Menzies Institute, Distinguished Professor Alison Venn, said this was an example of collaboration at its best. “The Royal Hobart Hospital has also been in partnership with us and the Baker Institute on this study.”

“Using the Biobus has meant we can continue with this research and follow up with the most vulnerable patients who are most at risk of readmission to hospital. I’m pleased we have been able to use an innovative approach at a time when people are unable to or afraid of accessing medical care.”

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