Stroke Association John Marshall Memorial Reader Award
NHS services for people with stroke have improved greatly in recent decades due to research that has changed clinical practice. However, improvements have mostly been for hospital-based treatments.
A large survey collected the views of almost 800 people with stroke asking them whether they felt adequately supported in the 1 – 5 years after leaving hospital. Respondents highlighted poor support for psychological difficulties such as the cognitive abilities of thinking, remembering and planning e.g. only 16% of people with memory or concentration difficulties felt their needs were being fully met.
To help people cope with cognitive problems, the NHS and other services in the community need research projects that provide them with proven therapies and rehabilitation strategies. Two recent National Clinical Guidelines for stroke have concluded that existing research is not adequate.
This award will allow me to increase my job to full-time, and I will be able to speed up the development of research to help people cope with cognitive problems. I will use some of the funding to offer training studentships to two postgraduate research students (PhDs). This means we can get started straightaway on designing and testing therapies, in collaboration with a wider team of NHS and research experts, and people who have experience of stroke.
I will also apply for additional training grants to develop the future workforce, as we need to plan ahead given the large amount of research needed in this area. Finally, I will apply for the large, and therefore expensive, research grants for the clinical trials needed to provide the robust evidence (effectiveness and value for money) that is required to make significant changes to clinical practice.
Award Type: Lectureship (Reader Award)
The Reader Award is intended for those whose qualifications and experience are either non-clinical and purely academic, or those who are clinically qualified but have now left clinical practice to embark upon a pure academic research career pathway. A Reader Award will only be awarded to those who are already Senior Lecturers at their University, in recognition of their personal distinction in their subject, and of their contribution to its advancement through scholarship and research.
Update 06/09/16: Audrey Bowen is currently the Stroke Association John Marshall Memorial Professor of Neuropsychological Rehabilitation at the University of Manchester.
Did Audrey achieve her aims?
Audrey achieved her aims that increase the likelihood, and bring forward hope, that research will find effective new treatments and therapies for psychological problems and improve the lives of people affected.
In total, Audrey supported 12 early career researchers to develop the skills and experience necessary to conduct high-quality research on new treatments for stroke. These awards had a value of over £529,000.
Audrey also secured funds for a number of research projects in stroke with a value of over £5.4million. The funders include UK-based National Institute for Health Research, Wellcome Trust and other European funders. Some of the funds are in the area of cognitive rehabilitation, others are for projects that include stroke patients with cognitive difficulties. This is because Audrey adapted her plans in response to new research and the opportunities available to work in the areas of greatest need.
A specific area of focus for Audrey was a cognitive disorder (called spatial neglect/inattention) that results in stroke patients not looking towards or moving on one side. As Chief Investigator on the SPATIAL trial, she led a team to find that it was possible and acceptable to conduct a large trial of therapy for stroke survivors with this cognitive problem that begins in the hospital, early after stroke.
The study found the particular therapy being trialled as part of occupational therapy, didn’t help to improve activities of daily living. However, they set a precedent for high-quality rehabilitation trials that can uncover effective treatments for the future.
Furthermore, Audrey established and led the International group on Spatial Attention and Neglect Disorders which aims to improve research and care for people with spatial neglect. Founding members come from across the world with a range of expertise. They are undertaking a range of activities including to build consensus and standardise definitions and taxonomy for neglect, and its screening in clinical practice.
How can this benefit patients?
Audrey has made significant progress in building the research workforce in the area of rehabilitation for stroke. She has also expanded the research methods that can be used to provide the robust evidence necessary for new treatments and therapies to be introduced into clinical practice. This has increased the likelihood, and bought forward the hope that research will find effective new treatments and therapies to improve the lives of people affected by stroke.
On completing this award Audrey said: “Thanks to generous donations to Stroke Association I have been able to work with stroke survivors and their families, health professionals and students. Together we have raised awareness of the impact of stroke on a person’s ability to think, concentrate, and interact. These are vital but vulnerable skills that many of us take for granted, until a stroke strikes and a brain fog descends affecting our relationships, work and play. There is much more research to do but thanks to donors there are many more of us now to speed up progress.”