Sri Lanka Launches HeadPoST – The Largest Nursing Trial in the World

RemediumOne, in collaboration with The George Institute for Global Health, has successfully launched Head Position in Stroke Trial (HeadPoST). HeadPoST is the largest nursing care trial in the world with the aim of recruiting a sample size of over 19,000 patients.

Stroke is one of the most common causes for death around the world, claiming 6.2 million lives worldwide. This number of 6.2 million, is greater than the deaths due to AIDS, Malaria and tuberculosis put together. Every sixty seconds, even as you read this, 6 people are dying of a stroke. As you read this, every two seconds, somewhere, someone is having a stroke. In Sri Lanka, stroke is the 4th leading cause of hospital deaths.

Approximately 80% of strokes worldwide are ischemic in nature. They are caused by an artery clot, resulting in an immediate reduction in the blood flow to the brain parenchyma. This leads to a loss of oxygen supply to the brain and death of the brain tissue. Currently, limited therapies are available for the treatment of stroke. Following clinical diagnosis of an ischemic stroke, most patients are treated with a modern thrombolytic therapy and a recombinant tissue plasminogen activator, which act to dissolve the clot and restore the blocked vessel to re-perfuse the ischemic region of the brain. Several observational studies have suggested a simpler way of increasing blood flow to the brain, which is to tilt the head of ischemic patients into a “lying flat” (0?) head position. However, insufficient evidence is available to recommend a specific head position for ischemic patients.

HeadPoST is a multicentre, prospective, cluster randomized crossover, blinded trial conducted to compare the effects of “lying flat” (0?) head position with sitting up (30?) position applied within the first 24 hours of admission, for patients with an ischemic stroke, on the outcome of death and disability at 90 days. Data will be collected for 24 hours following admission to the hospital and at a 90-day blinded follow-up assessment.

Currently, RemediumOne is working with four of the best government stroke units of the country, namely Colombo North Teaching Hospital, Colombo South Teaching Hospital and Sri Jayawardenapura General Hospital. The study coordinated internationally, across 140 hospitals, by the George Institute for Global Health, which is one of the top ten research institutes in the world. The study is sponsored through a grant from the National Medical Research Council of Australia (NHMRC), a major government health research body, from 2014 to 2016. The trial is expected to run till the end of 2016, with recruitment to finish by mid-2016.