SAFE – European Stroke Organisation https://eso-stroke.org the voice of stroke in Europe Tue, 26 Jul 2022 10:51:47 +0000 en-GB hourly 1 https://wordpress.org/?v=6.8.3 ESO welcomes the publication of the EU Healthier Together plan https://eso-stroke.org/eso-welcomes-the-publication-of-the-eu-healthier-together-plan/ Tue, 26 Jul 2022 10:51:47 +0000 https://eso-stroke.org/?p=23703 <p>The post ESO welcomes the publication of the EU Healthier Together plan first appeared on European Stroke Organisation.</p>

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DG Sante Healthier Together

ESO and SAFE welcome the publication of the EU Healthier Together plan

The European Commission recently launched the EU Non-Communicable Diseases Initiative – Healthier Together to reduce the burden of non-communicable diseases (NCD), including stroke, and improve health and wellbeing.

From December 2021 to May 2022, the Stroke Alliance for Europe (SAFE) and the European Stroke Organisation (ESO) worked closely together with DG Sante, the EU Commission department responsible for their policies on health and food safety, in the co-creation process for the EU NCD initiative.

This has resulted in the publication of a toolkit to guide Member states and EU policymakers towards a holistic and coordinated approach for health promotion and disease prevention, treatment and care, for diseases including stroke.

The plan covers the period from 2022-2027 and prioritises four disease groups including diabetes, cardiovascular diseases, chronic respiratory diseases, mental health and neurological disorders and health determinants for all major NCDs. Recognising its significant health burden and opportunities for improvement, we are delighted to see that stroke is specifically drawn out as a priority area under mental health and neurological disorders.

The initiative underlines the vital importance of implementing a national stroke plan, increasing public awareness, and improving screening, encompassing the entire chain of care from primary prevention to life after stroke.

This builds on the Stroke Action Plan for Europe (SAP-E), prepared by ESO and SAFE for the years 2018 to 2030.

We look forward to working with DG Sante and the European Commission in implementing the initiative to improve stroke prevention, care and life after stroke for all affected by stroke in Europe.

Harriet Priois, SAFE President added:

“We welcome this response by the European Commission to the ongoing efforts of the health community to prioritise non-communicable diseases (NCDs) on the EU agenda. We worked together with the European Stroke Organisation on a joint response to the consultation which was based on the Stroke Action Plan for Europe and the Essentials of Stroke care guideline.

We are delighted that stroke is drawn out as a priority area and that the Stroke Action Plan must be implemented across Europe. This initiative gives us a strong opportunity to raise the profile of stroke within our countries and we hope it will contribute to reducing the stroke burden, and improve the quality of life of those living with stroke in Europe.”

Click here to read the full report.

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ESOC 2022 Pre-Conference Meeting Report – Stroke Action Plan for Europe (SAP-E) https://eso-stroke.org/stroke-action-plan-for-europe-sap-e-workshop-at-esoc-2022-in-lyon/ Wed, 04 May 2022 11:12:56 +0000 https://eso-stroke.org/?p=22299 <p>The post ESOC 2022 Pre-Conference Meeting Report – Stroke Action Plan for Europe (SAP-E) first appeared on European Stroke Organisation.</p>

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By Hrvoje Budincevic, for ESO EAST Steering Committee

After several online meetings regarding Stroke Action Plan for Europe (SAP-E) on May 3rd, 2022 the SAP-E Workshop held as a face-to-face meeting of leadership and representatives involved in this project. Francesca R. Pezzella, Robert Mikulik, and Valeria Caso were moderators of the Workshop. Bo Norrving presented the overview of SAP-E, and Hanne Christensen reported the implementation of SAP-E. Arlene Wilkie, representing SAFE,  presented the lay perspective of SAP-E.

Guidelines and essentials of stroke care were presented by Thorsten Steiner. Cristina Tiu shared their experience in Romania in improving stroke care and the opportunities of SAP-E. Robert Mikulik shared experiences from ESO EAST that would be useful for SAP-E implementation.

SAP-E success stories were presented by Yuriy Flomin (Ukraine) via video, Ana Catarina Fonseca (Portugal), Fabrizio Pennacchi (Italy), and Nune Yeghiazaryan (Armenia).

The Presidents of ESO (Michael Dichgans)  and SAFE (Hariklia Proios) spoke on the importance of SAP-E for both of their organisations, stakeholders and stroke care in Europe. They presented awards to representatives from 6 countries (Bulgaria, Estonia, Italy, Germany, Greece,  and Serbia)  based on significant and exemplary efforts to support, lead, report, and promote the SAP-E in their countries.

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Declaration for Action on Stroke launches on European Stroke Awareness Day https://eso-stroke.org/declaration-for-action-on-stroke-launches-on-european-stroke-awareness-day/ Tue, 11 May 2021 11:43:41 +0000 https://eso-stroke.org/?p=18695 <p>The post Declaration for Action on Stroke launches on European Stroke Awareness Day first appeared on European Stroke Organisation.</p>

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An appeal is launched today (11 May 2021) for Health Ministries across Europe to sign the Declaration for Action on the Stroke Action Plan for Europe to tackle one of the leading causes of death and disability.

FOR IMMEDIATE RELEASE

Led by The European Stroke Organisation (ESO) and Stroke Alliance for Europe (SAFE), the initiative aims to encourage European countries to show their commitment to improving stroke prevention, treatment, care and support, by signing the Stroke Action Plan for Europe Declaration and add their voice to the fight against stroke across Europe.

It is estimated that over one million people in Europe have a stroke and 460,000 die as a result of a stroke every year and almost 10 million people are living with the impact of stroke. It is estimated that the number of people living with a stroke will rise by 26% within the next generation. Stroke causes large costs to healthcare budgets and societies. The costs related to stroke in Europe were recently estimated as high as €60 billion and are predicted to increase to rise to €86 billion, a 44% increase, by 2040.

Hanne Christensen, Professor of Neurology and Chair of the Stroke Action Plan for Europe says, ‘Stroke can be prevented and treated due to the significant discoveries over recent decades, however, there is still a significant gap between knowledge and the delivery of stroke services in spite of the high cost-effectiveness of stroke care. All stroke patients across Europe should have access to the best possible evidence-based care to ensure the best quality of life post stroke. Implementation of the Stroke Action Plan for Europe will help us achieve this.’

Francesca Romana Pezzella, Stroke Neurologist and Stroke Action Plan for Europe co-chair adds, ‘The Stroke Action Plan for Europe gives us a unified approach for stroke treatment and management to help us tackle inequalities in stroke care across European countries, which have been made worse by the coronavirus pandemic.’

The impact of stroke can be reduced by appropriate investment and organisation of services for prevention, treatment, support and care. To coordinate efforts to reduce the burden of stroke across Europe, the Stroke Action Plan for Europe was launched in 2018 by ESO and SAFE, representing stroke experts and patients from across Europe.

Arlene Wilkie, SAFE Director General and Stroke Action Plan for Europe implementation co-chair says,Led by The European Stroke Organisation (ESO) and Stroke Alliance for Europe (SAFE), the initiative aims to encourage European countries to show their commitment to improving stroke prevention, treatment, care and support, by signing the Stroke Action Plan for Europe Declaration and add their voice to the fight against stroke across Europe.

It is estimated that over one million people in Europe have a stroke and 460,000 die as a result of a stroke every year and almost 10 million people are living with the impact of stroke. It is estimated that the number of people living with a stroke will rise by 26% within the next generation. Stroke causes large costs to healthcare budgets and societies. The costs related to stroke in Europe were recently estimated as high as €60 billion and are predicted to increase to rise to €86 billion, a 44% increase, by 2040.

The aim of the Stroke Action Plan for Europe is to improve the entire stroke care pathway, from prevention and early treatment, to support and after-care. It will improve outcomes for patients and carers and will be highly cost effective for all countries in Europe. The Stroke Action Plan for Europe will also help reduce the burden of other non-communicable diseases. For example, implementation of appropriate prevention strategies for stroke will also reduce the incidence of dementia, heart disease, diabetes and obesity, which will have a significant impact on wellbeing, life expectancy, and healthcare costs.

ESO and SAFE have recently launched an implementation plan for the Stroke Action Plan for Europe reaching out to all 53 countries in the European region. The implementation plan will be adapted to each country to ensure its effectiveness, will help establish National Stroke Plans, and will provide tools to improve stroke prevention, treatment, support and care, including an online learning hub for stroke and a listing of evidence-based basic care elements.

Annual national summary data on the 12 Key Performance Indicators outlined in the Declaration, will be collected to allow for benchmarking both over time and within countries. This will provide each country with the knowledge and data it requires to continue to improve its implementation of its national plan.

Visit https://actionplan.eso-stroke.org/

For more information contact:
ESO Head Office
esoinfo@eso-stroke.org

Notes to editors

The Stroke Action Plan for Europe
To reduce the burden of stroke and address its long-term consequences, the European Stroke Organisation (ESO) and the Stroke Alliance for Europe (SAFE) published the Stroke Action Plan for Europe (SAP-E) 2018-2030. In consultation with 70 experts who reviewed the best practice evidence and current state of stroke care, the resulting plan sets out targets and recommendations across the whole care pathway that countries and healthcare systems across Europe can implement by 2030.
The SAP-E focuses on seven domains: primary prevention, organisation of stroke care; acute stroke care; secondary prevention, rehabilitation, evaluation of outcomes and life after stroke.

The SAP-E is a framework to drive healthcare policy, patient-focused care local stroke management and research priorities.

The SAP-E includes four targets for 2030:

  1. To reduce the number of strokes in Europe by 10%
  2. To treat 90% or more of all patients with stroke in Europe in a dedicated stroke unit as the first level of care
  3. To have national plans for stroke incorporating the whole chain of care from primary prevention through to life after stroke
  4. To fully implement national strategies for multisector public health interventions to promote and facilitate a healthy lifestyle and reduce environmental, socio-economic and educational factors that increase the risk of stroke.

About ESO
The European Stroke Organisation (ESO) is a pan-European society of stroke researchers and physicians, national and regional stroke societies and lay organisations founded in 2007. The aim of ESO is to reduce the burden of stroke by changing the way that stroke is viewed and treated. This can only be achieved by professional and public education, and by making institutional changes. ESO serves as the voice of stroke in Europe, taking action to reduce the burden of stroke regionally and globally.
www.eso-stroke.org

About SAFE
The Stroke Alliance for Europe (SAFE) an international non-profit-making organisation formed in 2004 in Brussels, Belgium. It is the voice of stroke patients in Europe, representing a range of stroke support organisations from more than 30 European countries.
SAFE’s goal is to decrease the number of strokes in Europe by advocating for better prevention, access to adequate treatment, post-stroke care and rehabilitation.
For more information about SAFE, please visit www.safestroke.eu.

The aim of the Stroke Action Plan for Europe is to improve the entire stroke care pathway, from prevention and early treatment, to support and after-care. It will improve outcomes for patients and carers and will be highly cost effective for all countries in Europe. The Stroke Action Plan for Europe will also help reduce the burden of other non-communicable diseases. For example, implementation of appropriate prevention strategies for stroke will also reduce the incidence of dementia, heart disease, diabetes and obesity, which will have a significant impact on wellbeing, life expectancy, and healthcare costs.

ESO and SAFE have recently launched an implementation plan for the Stroke Action Plan for Europe reaching out to all 53 countries in the European region. The implementation plan will be adapted to each country to ensure its effectiveness, will help establish National Stroke Plans, and will provide tools to improve stroke prevention, treatment, support and care, including an online learning hub for stroke and a listing of evidence-based basic care elements.

Annual national summary data on the 12 Key Performance Indicators outlined in the Declaration, will be collected to allow for benchmarking both over time and within countries. This will provide each country with the knowledge and data it requires to continue to improve its implementation of its national plan.

Visit https://actionplan.eso-stroke.org/

For more information contact:
ESO Head Office
esoinfo@eso-stroke.org

Notes to editors

The Stroke Action Plan for Europe
To reduce the burden of stroke and address its long-term consequences, the European Stroke Organisation (ESO) and the Stroke Alliance for Europe (SAFE) published the Stroke Action Plan for Europe (SAP-E) 2018-2030. In consultation with 70 experts who reviewed the best practice evidence and current state of stroke care, the resulting plan sets out targets and recommendations across the whole care pathway that countries and healthcare systems across Europe can implement by 2030.
The SAP-E focuses on seven domains: primary prevention, organisation of stroke care; acute stroke care; secondary prevention, rehabilitation, evaluation of outcomes and life after stroke.

The SAP-E is a framework to drive healthcare policy, patient-focused care local stroke management and research priorities.

The SAP-E includes four targets for 2030:

  1. To reduce the number of strokes in Europe by 10%
  2. To treat 90% or more of all patients with stroke in Europe in a dedicated stroke unit as the first level of care
  3. To have national plans for stroke incorporating the whole chain of care from primary prevention through to life after stroke
  4. To fully implement national strategies for multisector public health interventions to promote and facilitate a healthy lifestyle and reduce environmental, socio-economic and educational factors that increase the risk of stroke.

About ESO
The European Stroke Organisation (ESO) is a pan-European society of stroke researchers and physicians, national and regional stroke societies and lay organisations founded in 2007. The aim of ESO is to reduce the burden of stroke by changing the way that stroke is viewed and treated. This can only be achieved by professional and public education, and by making institutional changes. ESO serves as the voice of stroke in Europe, taking action to reduce the burden of stroke regionally and globally.
www.eso-stroke.org

About SAFE
The Stroke Alliance for Europe (SAFE) an international non-profit-making organisation formed in 2004 in Brussels, Belgium. It is the voice of stroke patients in Europe, representing a range of stroke support organisations from more than 30 European countries.
SAFE’s goal is to decrease the number of strokes in Europe by advocating for better prevention, access to adequate treatment, post-stroke care and rehabilitation.
For more information about SAFE, please visit www.safestroke.eu.

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Stroke prevention – we can do better! https://eso-stroke.org/stroke-prevention-we-can-do-better/ Fri, 04 Dec 2020 14:12:05 +0000 https://eso-stroke.org/?p=17062 <p>The post Stroke prevention – we can do better! first appeared on European Stroke Organisation.</p>

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By Kateriine Orav, Department of Neurology, North Estonia Medical Center, Tallinn, Estonia

 As vast resources are invested into acute stroke treatment we should not forget that about 90% of strokes are attributable to ten common, potentially modifiable risk factors.1

With emerging evidence on more effective stroke prevention strategies there remains a considerable gap between risk factor control recommended by guidelines and real-world stroke prevention.  Boehme et al. found that adequate control of the five most relevant risk factors combined (hypertension, hypercholesterolemia, atrial fibrillation, smoking and overweight) might have prevented ≈1 of 2 strokes. In their study, 80% of TIA and ischemic stroke patients had at least one indaequately treated risk factor. Alarmingly patients with recurrent strokes showed even more inadequately treated risk factors than patients with first-ever events. The authors contributed these finding to the absence of standardized post-acute treatment follow-up visits in the study area.2 The ESO/SAFE survey identified significant gaps in secondary prevention across Europe, with limited specialist follow-up, poor levels of adherence to medications and uneven availability of advanced investigations such as prolonged cardiac monitoring. Only 54% of countries reported having national strategies that incorporated secondary prevention.3

What should be done?

The 2019 update of recommendations for the establishment of stroke systems by the American Stroke Association also points out that a barrier to improving secondary prevention is the lack of structure in the paths that stroke patients and their caregivers experience. Therefore, the guidelines recommend that support systems are necessary to ensure that all patients have appropriate follow-up with specialized stroke services when needed and primary care arranged on discharge.4

 

Can support programmes help?

A 2018 Cochrane meta-analysis found that organizational interventions may be associated with improved blood pressure control but there was no clear evidence for other risk factors or a reduced incidence of cardiovascular events. However, several of the included studies demonstrated improved medication adherence among the intervention group patients. Multidisciplinary team members were usually involved in the studies where an intervention was associated with an improved outcome on secondary prevention and often included a combination of patient education and regular monitoring. The benefits of a multidisciplinary team may be associated with a collective consideration of the whole patient due to a variation in knowledge, specialisation and experience.5

More recently, the STROKE-CARD trial found that an easily implementable stroke follow-up programme by a multidisciplinary stroke team reduced cardiovascular risk and improved health-related quality of life and functional outcome one year after ishemic stroke and TIA.6 A randomized controlled study reported by Ahmadi et al. evaluated a multicomponent support programme for secondary prevention in TIA and minor stroke patients which led to 8-17% higher rates of patients who achieved various secondary prevention targets (including blood pressure, LDL-levels, physical activity and smoking cessation).7

The recently published study by Ullberg et al. evaluated the feasibility of a comprehensive and structured three-month follow up programme in community dwelling stroke survivors using a modified Post-stroke checklist. The nurse-led interview was followed by multi-disciplinary team meetings. Stroke-related health problems were present in 93% of patients. Secondary prevention problems were highly prevalent necessitating interventions in 62% of patients. The study concluded that follow-up of stroke patients using a post-stroke checklist was feasible and highly relevant. We will eagerly wait for data of the 12-month follow-up.8

To conclude, organized stroke care in the postacute period is essential to improve secondary prevention in stroke patients. However, as secondary prevention programmes can be resource intensive, we need a better understanding of which aspects of different interventions actually work. With an increasing burden of stroke in Europe effective prevention strategies are more important than ever.9

References:

  1. O’Donnell MJ, Chin SL, Rangarajan S, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. 2016 Aug 20;388(10046):761-75.
  2. Boehme C, Toell T, Mayer L, et al. The dimension of preventable stroke in a large representative patient cohort. 2019 Dec 3;93(23):e2121-e2132.
  3. Webb A, Heldner MR, Aguiar de Sousa D, et al. ESO-SAFE Secondary Prevention Survey Steering Group. Availability of secondary prevention services after stroke in Europe: An ESO/SAFE survey of national scientific societies and stroke experts. Eur Stroke J. 2019 Jun;4(2):110-118.
  4. Adeoye O, Nyström KV, Yavagal DR, et al. Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update. Stroke. 2019 Jul;50(7):e187-e210.
  5. Bridgwood B, Lager KE, Mistri AK, et al. Interventions for improving modifiable risk factor control in the secondary prevention of stroke. Cochrane Database Syst Rev. 2018;5(5):CD009103.
  6. Willeit P, Toell T, Boehme C, et al. STROKE-CARD study group. STROKE-CARD care to prevent cardiovascular events and improve quality of life after acute ischaemic stroke or TIA: A randomised clinical trial. EClinicalMedicine. 2020;25:100476.
  7. Ahmadi M, Laumeier I, Ihl T, et al. A support programme for secondary prevention in patients with transient ischaemic attack and minor stroke (INSPiRE-TMS): an open-label, randomised controlled trial. Lancet Neurol. 2020;19(1):49-60.
  8. Ullberg T, Mansson K, Berhin I, et al. Comprehensive and Structured 3-month Stroke Follow-up Using the Post-stroke Checklist (The Struct-FU study): A Feasibility and Explorative Study. Journal of Stroke and Cerebrovascular Diseases, 2021;30(2)
  9. Wafa HA, Wolfe CDA, Emmett E, et al. Burden of Stroke in Europe: Thirty-Year Projections of Incidence, Prevalence, Deaths, and Disability-Adjusted Life Years. Stroke. 2020;51(8):2418-2427.

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ESO and SAFE kick-off the implementation of the Stroke Action Plan for Europe (SAP-E) –a major initiative to reduce the burden of stroke in Europe https://eso-stroke.org/eso-and-safe-kick-off-the-implementation-of-the-stroke-action-plan-for-europe-sap-e-a-major-initiative-to-reduce-the-burden-of-stroke-in-europe/ Mon, 14 Sep 2020 10:36:36 +0000 https://eso-stroke.org/?p=15905 <p>The post ESO and SAFE kick-off the implementation of the Stroke Action Plan for Europe (SAP-E) –a major initiative to reduce the burden of stroke in Europe first appeared on European Stroke Organisation.</p>

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10.09.2020 Basel – European Stroke Organisation (ESO) and Stroke Alliance for Europe (SAFE) initiated the implementation phase of the Stroke Action Plan for Europe 2018-2030, with a virtual meeting of over 80 experts from 52 countries, each involved within their national scientific societies or stroke support organisations.

The Stroke Action Plan sets targets for 2030 that include a major reduction in new strokes, stroke unit care as first level of care, and national plans for stroke services. At present, less than half of all patients with stroke in Europe receive appropriate care, with large inequalities between and within countries. By adopting evidence based principles of prevention and care, the burden of stroke in Europe can be substantially reduced with large cost savings for the society.

In his introduction, ESO President Prof. Martin Dichgans, Munich reinforced the initiative’s overall goal of creating a framework that will assist countries to improve stroke care across Europe. It is “only with the involvement, collaboration and joint effort of you, the representatives of national scientific societies and patient organisations, that this aim can be achieved”, he said.

The SAP-E Steering Committee presented detailed insights regarding the preparation work and achievements to date as well as an outlook for the upcoming years.

Arlene Wilkie, SAFE Director General, identified the major unmet needs from the perspective of patients and carers in the different regions of Europe. Prof. Hanne Christensen, Copenhagen outlined how the Stroke Action Plan shall be implemented on a national level: “By signing a SAP-E declaration, Ministries of Health, Stroke Support Organisations and Stroke Scientific Societies commit to support and act proactively within the plan in their countries to reach the targets of SAP-E”.

Components of the plan include prevention, care, surveillance, and monitoring of key performance indicators across Europe. As a pan-European initiative, SAP-E will convene authorities, health care providers and patients together to reduce the burden of stroke by a collaborative and systematic effort. The SAP-E is the largest stroke project ever undertaken in Europe.

The official Stroke Action Plan for Europe publication and further detailed information can be found on the Action Plan Website. https://actionplan.eso-stroke.org/

Contact:

ESO Head Office

esoinfo@eso-stroke.org

About ESO

The European Stroke Organisation (ESO) is a pan-European society of stroke researchers and physicians, national and regional stroke societies and lay organisations founded in the 2007. The aim of the ESO is to reduce the burden of stroke by changing the way that stroke is viewed and treated. This can only be achieved by professional and public education, and by making institutional changes.

ESO serves as the voice of stroke in Europe, taking action to reduce the burden of stroke regionally and globally. www.eso-stroke.org

About SAFE

The Stroke Alliance for Europe (SAFE) is an international non-profit-making organisation formed in 2004 in Brussels, Belgium. It is the voice of stroke for patients in Europe, representing a range of stroke support organisations from more than 30 European countries. SAFE’s goal is to decrease the number

of strokes in Europe by advocating for better prevention, access to adequate treatment, post-stroke care and rehabilitation. For more information about SAFE, please visit www.safestroke.eu

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Stroke Action Plan Europe: first steps towards implementation https://eso-stroke.org/stroke-action-plan-europe-first-steps-towards-implementation-2/ Tue, 24 Sep 2019 10:09:49 +0000 https://eso-stroke.org/?p=12082 Committee Members In Photo L-R: Luzia Balmer, Urs Fischer, Diana Aguiar de Sousa, Jelena Misita, Valeria Caso – Advisor, Martin Dichgans, Bo Norrving – Advisor, Hanne Christensen, Cristina Tiu, Robert Mikulik, Markus Wagner, Francesca Romana Pezzella, Grethe Lunde, Bart van der Worp (not pictured) One year after the publication of the Stroke Action Plan for […]

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Committee Members

In Photo L-R: Luzia Balmer, Urs Fischer, Diana Aguiar de Sousa, Jelena Misita, Valeria Caso – Advisor, Martin Dichgans, Bo Norrving – Advisor, Hanne Christensen, Cristina Tiu, Robert Mikulik, Markus Wagner, Francesca Romana Pezzella, Grethe Lunde, Bart van der Worp (not pictured)

One year after the publication of the Stroke Action Plan for Europe the Steering Committee Implementation, consisting of ESO and SAFE members, met for the first time at the end of August to discuss KPIs for each of the seven domains of the Action Plan, strategy framework and dissemination.

The central role of both national professional stroke societies and stroke support and patients organization in the realization of the project was evident as well as the importance of registers to drive actions at multiple level in order to achieve the stroke action plan goals and targets by 2030.

There are wide inequalities in access to care and in the offer of the type of treatment for stroke patients in Europe, the Action Plan aims not only to improve the treatment and containment strategies of the disease but also to make it more easily accessible through evidence based policies throughout the whole European Region.

This necessitates a careful mapping of national, regional and local realities against the action plan seven domain KPIs and close collaboration with all national stake holders, such as governmental bodies, active national stroke societies, European agencies, and all current initiatives in the field of improving stroke care such as the recently established IRENE- Implementation Research Network in Stroke Care Quality; the valuable work carried out by the individual ESO committees will also contribute to the implementation of this project.

Contacts with interlocutors such as EAN, WSO, WHO, national societies, with which to build synergies have already been started or will soon be.

In terms of dissemination the need to effectively communicate outside the activities that take place for the implementation of the action plan is crucial to its success, the scientific community and the public in general will be informed by various means, social networks, press releases, and certainly, from now on, it will be our care to inform constantly also through the ESO newsletter.

It is our intention to make the realization of this project as participatory as possible, this is certainly a key element of success and to be able to reach the goals set for ten years from now.

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Stroke Plans and Prehospital Care in Europe https://eso-stroke.org/stroke-plans-and-prehospital-care-in-europe/ Tue, 19 Mar 2019 09:07:06 +0000 https://eso-stroke.org/?p=10494 Original research article: Abilleira S, Aguiar de Sousa D, Gattringer T, Kobayashi A, Fazekas F, Szikora I, et al. Planning of stroke care and urgent prehospital care across Europe: Results of the ESO/SMINT/EAN/SAFE Survey European Stroke Journal. 2019 (1) https://doi.org/10.1177/2396987319837106 Stroke Plans and Prehospital Care in Europe Comment by Helge Fagerheim Bugge, MD, Mona Guterud, […]

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Original research article: Abilleira S, Aguiar de Sousa D, Gattringer T, Kobayashi A, Fazekas F, Szikora I, et al. Planning of stroke care and urgent prehospital care across Europe: Results of the ESO/SMINT/EAN/SAFE Survey European Stroke Journal. 2019 (1) https://doi.org/10.1177/2396987319837106

Stroke Plans and Prehospital Care in Europe

Comment by Helge Fagerheim Bugge, MD, Mona Guterud, Paramedic MSc, Else Charlotte Sandset, MD PhD, and Maren Ranhoff Hov, MD PhD

In a paper published in the European Stroke Journal today (1), Abilleira and colleagues report the availability and adequacy of stroke care plans and organised prehospital care across Europe, and explore their association with the national rates of reperfusion therapies for stroke, by using data from the ESO-ESMINT-EAN-SAFE survey on stroke care in Europe (2) .

The European Stroke Organization’s Action Plan for Stroke in Europe (3) recommends that all European countries have national stroke plans and a national stroke registry; a goal that is not yet achieved according to the paper. Currently 37/44 countries in the survey have a stroke care plan at national and/or regional level, while six countries have stroke plans solely at a local level. Stroke care plans across Europe displays substantial variation and are not necessarily comprehensive, often lacking an approach to the whole continuum of stroke care. Most plans only include acute stroke care, both prehospitally and in-hospital, whereas plans including post-acute care and rehabilitation are absent in most countries.

Importantly, it is shown that more patients in countries with a national stroke plan receive reperfusion treatment when compared with countries with regional, local or no stroke plan. As the authors point out, “organisation is also curative” in diseases where time is of the utmost importance for treatment and patient outcome. In order to give the optimal treatment, personnel in the entire stroke treatment chain needs clear protocols to avoid time delays, from emergency dispatch services to in-hospital stroke physicians.

Monitoring treatment practice through a national stroke registry also seems to have impact on care. In the 14 countries with national registries in place, patients received both intravenous thrombolysis (IVT) and endovascular treatment (EVT) at a higher rate, compared to the 28 countries without national registry data. Being a descriptive study, this article cannot point to a cause-effect regarding a correlation between a registry and more patients receiving reperfusion therapy, but it’s likely that by having a national registry, practice is monitored, one can easily compare the practice of one hospital with that of another and thereby identify areas in which improvement are necessary.

In addition to stroke plans and stroke registers, the one factor significantly associated to higher reperfusion rates was the routine use of non-medicalised ambulances (staffed with technician). Particularly, compared to medicalised ambulances (staffed with general physician and nurse), countries using mostly non-medical ambulances achieved over twice the number of IVT’s and more than eight times higher EVT rates.

As the authors of this article so accurately points out, a multifaceted approach is needed to turn around the burden of stroke in Europe. Politicians and health officials need to prioritize and facilitate the national stoke plans and stroke registries in all European countries. Stroke plans need to encompass the entire treatment chain, from emergency dispatch services to rehabilitation. Whereas, focus often is on in-hospital protocols, minimising door-to-needle times and door-in-door-out times, many stroke patients are already missed at this point.

Recognition of stroke by health care professionals is the second step in improving stroke care (patient recognition being the first). We strongly believe that, prehospital personnel need further education in quick on-scene recognition, and triage of stroke patients needs to be addressed. In addition, we need to secure prompt transfer and improve communication between prehospital and in-hospital services, as well as thorough follow-up, rehabilitation and preparation of patients for a life after stroke.

References

  1. Abilleira S, Sousa DAd, Gattringer T, Kobayashi A, Fazekas F, Szikora I, et al. Planning of stroke care and urgent prehospital care across Europe: Results of the ESO/SMINT/EAN/SAFE Survey European Stroke Journal. 2019.
  2. Aguiar de Sousa D, von Martial R, Abilleira S, Gattringer T, Kobayashi A, Gallofré M, et al. Access to and delivery of acute ischaemic stroke treatments: A survey of national scientific societies and stroke experts in 44 European countries. European Stroke Journal. 2018;4(1):13-28.
  3. Norrving B, Barrick J, Davalos A, Dichgans M, Cordonnier C, Guekht A, et al. Action Plan for Stroke in Europe 2018–2030. European Stroke Journal. 2018;3:309-36.

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Europe comes together on how to tackle stroke – Action Plan for Stroke in Europe 2018–2030 https://eso-stroke.org/europe-comes-together-on-how-to-tackle-stroke-action-plan-for-stroke-in-europe-20182030/ Mon, 29 Oct 2018 09:56:02 +0000 https://eso-stroke.org/?p=9511 ESO, together with the patient organization SAFE, has published today its action plan for the implementation of evidence-based preventive actions and stroke services in the next decade. Authors: Diana Aguiar de Sousa, Linxin Li, Else Charlotte Sandset On 29 October 2018,  World Stroke Day, ESO and SAFE publish the Action Plan for Stroke in Europe […]

<p>The post Europe comes together on how to tackle stroke – Action Plan for Stroke in Europe 2018–2030 first appeared on European Stroke Organisation.</p>

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ESO, together with the patient organization SAFE, has published today its action plan for the implementation of evidence-based preventive actions and stroke services in the next decade.

Authors: Diana Aguiar de Sousa, Linxin Li, Else Charlotte Sandset

On 29 October 2018,  World Stroke Day, ESO and SAFE publish the Action Plan for Stroke in Europe 2018-2030, available for download free of charge, from the European Stroke Journal webpage1.

Novel methodological approach

This third European Stroke Action plan (ESAP) comes at a time when stroke remains one the leading causes of death and disability in Europe, despite the overwhelming evidence that this is a preventable and treatable disease, whose burden would be dramatically reduced if all the evidence based strategies could be implemented. ESAP has a comprehensive coverage including seven domains: primary prevention, organization of stroke services, management of acute stroke, secondary prevention, rehabilitation, evaluation of stroke outcome and quality assessment and life after stroke.

Seven working groups, one for each domain, prepared this document, under coordination of the steering committee. Importantly, patient organization representatives were included in all working groups. Besides, the draft documents were then open to public comments during a one-month period and the final workshop was streamed live, facilitating public scrutiny, both within and outside the society.

Definition of four overarching targets

The document includes an overview of the current state of stroke management in Europe, as well as specific targets and research priorities for stakeholders. Overall, 30 targets and 72 research priorities are listed in the plan. But, undoubtedly, one of the most important sections in this plan is the part with the four overarching targets that are expected to be achieved by 2030:

  1. Reduction of the absolute number of strokes in Europe by 10%;
  2. Treatment of at least 90% of stroke patients in a dedicated stroke unit;
  3. Implementation of national plans for stroke in all countries;
  4. Full implementation of national strategies for multi-sector public health interventions (healthy lifestyle, environmental pollution, socioeconomic and educational risk factors for stroke).

Implementation is being planned

While ESAP provides a road map for what should be the top strategic priorities of stroke care in the next decade, efforts are now directed at establishing an implementation plan.  An epidemiological analysis, currently in preparation, will contribute to this work.

Finally, the key research pipeline priorities are also discussed in this consensus document, as well as the need of commitment and involvement of the pharmaceutical industry, funding agencies and academia.

Prof. Bo Norrving, chair of the Steering Committee, believes “Stroke has an enormous potential to be prevented, and the burden of stroke can be significantly reduced by joint efforts from professionals, patient organisations, administrators, and governmental bodies. The earlier the targets can be reached, the better. While we are discussing and planning, patients continue to suffer and opportunities to prevent and treat are missed.”

In sum, the European Stroke Action Plan reviews the current evidence, identifies prioritized areas of research and sets the targets in stroke care for the coming years. This is therefore a document that concerns all of us, from stroke physicians to national and European stakeholders. We ask for the help and involvement of all of you in supporting this action plan to be fulfilled.

References

  1. Norrving B, Barrick J, Davalos A et al. Action Plan for Stroke in Europe 2018-2030. Eur Stroke J 2018 Out 29

 

Stroke has an enormous potential to be prevented, and the burden of stroke can be significantly reduced by joint efforts from professionals, patient organisations, administrators, and governmental bodies. The earlier the targets can be reached, the better. While we are discussing and planning, patients continue to suffer and opportunities to prevent and treat are missed.

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ESO and SAFE announce the publication of European Stroke Action Plan (ESAP) in the European Stroke Journal https://eso-stroke.org/eso-and-safe-announce-the-publication-of-european-stroke-action-plan-esap-in-the-european-stroke-journal/ Mon, 29 Oct 2018 09:05:15 +0000 https://eso-stroke.org/?p=9480 FOR IMMEDIATE RELEASE 29.10.2018 Basel – European Stroke Organisation (ESO) and Stroke Action for Europe (SAFE) are proud to announce the publication of the European Stroke Action Plan (ESAP) in the European Stroke Journal (ESJ). The ESAP is available online first as of 29 October 2018, World Stroke Day.  The ESAP is a truly collaborative […]

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FOR IMMEDIATE RELEASE

29.10.2018 Basel – European Stroke Organisation (ESO) and Stroke Action for Europe (SAFE) are proud to announce the publication of the European Stroke Action Plan (ESAP) in the European Stroke Journal (ESJ). The ESAP is available online first as of 29 October 2018, World Stroke Day.  The ESAP is a truly collaborative document resulting from more than a year of dedicated efforts from ESO, SAFE and countless stakeholders. The ESAP addresses the entire chain of care from primary prevention through to live after stroke. The aim of the ESAP is to set a roadmap and define goals for the treatment of stroke in Europe through 2030. The ESAP and related information is available at www.actionplan.eso-stroke.org.

The plan was formally launched in the EU Parliament on 23 May 2018. Since its launch, the authors have been gathering feedback and working on revisions to publish a comprehensive document for wide spread access. By 2030, the ESAP aims to:

  • Reduce the absolute number of strokes in Europe by 10%.
  • Treat 90% of all patients with stroke in Europe in a stroke unit as the first level of care.
  • Have national plans for stroke encompassing the entire chain of care.
  • Fully implement national strategies for multi-sectorial public health interventions promoting and facilitating a healthy life-style, and reducing environmental (including air pollution), socio-economical and educational factors that increase the risk of stroke.

Free access to the complete ESAP is available on the Action Plan Website.

In order to support the achievement of goals set forth in the ESAP, ESO works closely with national representatives in the ESO-EAST project, established in 2015, supports the ANGELS programme and Registry of Stroke Care Quality (RES-Q). The ESO Guidelines Board is continuously working to refine and publish guidelines for stroke treatment.

In addition, ESO recognizes the efforts of its Organisational members who have put on various awareness campaigns for this year`s World Stroke Day. An index of WSD activities conducted by our Organisational members is available on the ESO blog. #ESAP

 

Contact:

ESO Head Office

esoinfo@eso-stroke.org

 

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