Bulgaria in the fight against stroke: Overcoming the challenges to achieve progress
On the occasion of the third in-person SAP-E National Coordinators workshop, held on 20-22 January 2025 in Sofia (Bulgaria), a press conference was organised by the Association for Stroke and Aphasia and the Bulgarian Society of Neurology.
The main topic was the presentation of the updated Stroke Action Plan for Europe 2018-2030 and Bulgaria’s progress to overcome the burden of stroke.
Half-time achievements and success stories from the Stroke Action Plan
Stroke is one of the most enormous burdens to healthcare services. Despite all combined efforts, it affects more than one million people annually in Europe.
Although there is abundant knowledge regarding stroke prevention and treatment, still remains a significant gap between the theory and real-world stroke care, even in the most developed European countries. The Stroke Action Plan-Europe (SAP-E) demonstrated in its first 5 years a massive inequality in providing stroke care in Europe. The disparity exists not only among different countries, but also inside every respective country in different regions.
To know more about how the SAP-E has been advocating for better stroke care outcomes since its inception and playing a crucial role in shaping stroke care practices in Europe, read the latest update here.
Malta becomes the 14th country to sign the Stroke Action Plan for Europe Declaration
Congratulations!
We are very pleased to announce that Malta is the 14th country to endorse the Declaration for Action on Stroke and enact the Stroke Action Plan for Europe, bringing the country another step closer to guaranteeing the highest standard of care and support for stroke patients.
Stroke remains one of the leading causes of death and disability in Europe, and projections show that with a ‘business as usual’ approach, the burden of stroke will continue to increase by 25 % in the next decade and beyond. To drastically reduce the burden of stroke and its long-term consequence, we convened to review the scientific evidence and the state of current services and to set targets for the development of stroke care for the decade to follow. The SAP-E Declaration lists all 12 Key Performance Indicators in order to monitor and facilitate change.
Find out more about the Declaration on this page.
Action Plan Publication update - Online Plenum meeting
The “Action Plan for Stroke in Europe” publication is being updated to a 2.0 version.
As significant scientific developments have happened since 2018 and new data has been released, the Domain Working groups, composed of original contributors and new members, have again been asked to provide their input on the respective domains.
The update is now entering its final phase and all stakeholders will have the opportunity to comment and contribute to that discussion, during the upcoming online plenum meeting: Tuesday 27 August 2024, from 9:00 to 15:00 CEST.
The programme will feature presentations by the Domain groups and discussions on each domain, as well as the section on translational research, as well as discussions with participants.
The detailed programme can be found here.
The meeting will be upon registration only: Click here to register.
New SAP-E Data release on European Stroke Awareness Day 2024
Europe takes small steps forward to improve stroke care and support, but too many inequities still persist
The latest data from the Stroke Action Plan for Europe (SAP-E) Stroke Service Tracker (SST) shed light on Europe’s journey toward better stroke care and support. While there are positive signs of progress, the report also reveals persistent gaps and challenges, highlighting the continued need for nationally targeted interventions.
The SST, which examines 12 key areas of stroke care improvement, shows positive strides in meeting SAP-E targets and improving acute treatment, organisation and quality control of services. Several countries, including the Republic of Moldovia, Bulgaria, Czech Republic, Estonia, Norway, Portugal, Romania, Sweden, and Wales are making commendable progress.
However, access to stroke unit care, follow-up and life after stroke services and support remains uneven. Disparities in care provision across regions underscore the need for targeted interventions to ensure equitable access to quality care and support for all affected by stroke.
The data underscore the urgent need for national stakeholders to address these gaps. By leveraging this information, countries must implement tailored stroke strategies to ensure that everyone affected by stroke receives timely, high-quality care and support, regardless of their location or socioeconomic status.
We urge all European countries to continue to harness the power of their SST data to bridge gaps in their stroke care. Let’s prioritise action and ensure every stroke patient receives the care they deserve.
Prevent, treat and support: An EU election manifesto for stroke survivors
The Stroke Alliance for Europe (SAFE) and the European Stroke Organisation (ESO) today launch their joint EU MEP Election Manifesto 2024. For the elections in June we are asking MEP candidates to support improving health across the EU with a focus on improving prevention, care and support of those affected by stroke across Europe.
Every year, nearly 1.5 million people suffer a stroke in 32 European countries1. Stroke can be devastating – leading to death or life-long disability2, shattering the lives of victims and their loved ones. Those who survive will join the more than 9 million European stroke survivors who live with long term health, social, and financial impacts3.
The EU Non-Communicable Disease Initiative, Healthier Together, launched by the European Commission in 2022, provides opportunities for policy action that both EU-level and national policymakers should build on. We call upon all EU level policymakers, to prioritise stroke in health policies, to support member states to develop national stroke plans and lead research into the under-examined areas of stroke.
Following the principles of the Stroke Action Plan for Europe, SAFE and ESO are calling for the implementation of the following policy proposals:
- Prior to a stroke
- Primary prevention and risk factor control
- Implement legislation for public health interventions
- Implement risk factor screening and treatment programmes
- Amidst the stroke
- Quality of care and stroke management
- Ensure equal access to acute stroke care
- Establish a quality improvement system for stroke services
- Life after stroke
- Prevent further stroke and take care of those who had one
- Implement post-rehabilitation personal care plans that offer non-medical support
- Provide sufficient secondary prevention services
- Guarantee equitable access to rehabilitation prior and post discharge
- Develop a European framework of reference for stroke care quality
- Empower a dignified life after stroke
- Understanding stroke
- Provide sufficient research funding
- Improve stroke services with better data
- Encourage research into under-examined areas of stroke
Click here for the full manifesto:
References:
- At what cost: The economic impact of stroke in Europe. University of Oxford for the Stroke Alliance for Europe (SAFE).
- Sudharsanan, N., Deshmukh, M., & Kalkonde, Y. (2019). Direct estimates of disability-adjusted life years lost due to stroke : a cross-sectional observational study in a demographic surveillance site in rural Gadchiroli, India. BMJ open, 9(11), e028695.
https://doi.org/10.1136/bmjopen-2018-028695. - Wafa, H. A., Wolfe, C. D. A., Emmett, E., Roth, G. A., Johnson, C. O., & Wang, Y. (2020). Burden of Stroke in Europe: Thirty-Year Projections of Incidence, Prevalence, Deaths, and Disability-Adjusted Life Years. Stroke, 51(8), 2418–2427. https://doi.org/10.1161/STROKEAHA.120.029606.
The Czech Republic signs the Stroke Action Plan for Europe declaration
Congratulations!
We are very pleased to announce that the Czech Republic is the 13th country to endorse the Declaration for Action on Stroke and enact the Stroke Action Plan for Europe, bringing the country another step closer to guaranteeing the highest standard of care and support for stroke patients.
The document summarises the aims of the implementation of the Stroke Action Plan for Europe and by signing it, the governmental bodies in each country manifest their commitment to
- acknowledge that cerebrovascular diseases, including stroke, are among the major causes of premature death long term disability, and cognitive decline
in the adult population of Europe, and that many strokes are preventable and treatable with evidence-based and cost-effective strategies ; - support the Stroke Action Plan for Europe with the four overarching targets for 2030: (1) to reduce the absolute 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
encompassing the entire chain of care, (4) to fully implement national strategies for multisector public health interventions - align with the WHO Global Action Plan for Prevention and Control of Noncommunicable Diseases 2013-2020 that aims for a 25% relative reduction in
premature mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases by 2025.
Find out more about the Declaration on this page.
2023 SAP-E Annual Status Report
The 2023 Status Report emphasizing this year’s Stroke Action Plan-Europe achievements by the European Stroke Organisation (ESO) and Stroke Alliance for Europe (SAFE) is now available.
With the participation of 42 delegates representing 34 countries, the first on-site SAP-E National Coordinators’ meeting in Riga, Estonia in March has been one of the highlights of the year. The two-day programme included sharing experiences, workshops’ discussions and introduction of the new leadership structure, including regional spokespersons.
The SAP-E Steering Committee maintains its momentum by extending the successes attained in the present year:
- Establishment of elected regional spokespersons to support National Coordinators and optimise communication
- Presentation of the Stroke Service Tracker (SST) data and regional status update by regional spokespersons during ESOC 2023
- Relaunch of the SAP-E website in May and continuous updates throughout the year to facilitate visualisation of yearly stroke data
- Publication of the lay version of the Essentials of Stroke Care listing primordial evidence-based steps during pre-hospital, hospital stroke care and life after stroke
- Signature of the SAP-E Declaration by 12 countries
- Communication campaign and joint ESO-SAFE statement on 2023 European Stroke Awareness Day
The end of 2023 will be dedicated to strengthening our presence and advocacy activities at the EU level, starting the 2022 data collection for the SST and preparing the second on-site National Coordinators meeting in January 2024.
View the full status report here.
SAP-E data release on ESAD 2023
New data collected as part of the Stroke Action Plan for Europe (SAP-E) Stroke Service Tracker reveals the gross inequity of access to care and support for stroke patients and stroke survivors across Europe.
Key findings from the data show:
- There is inequity in access to stroke care throughout Europe, and insufficient access to care in many high-income countries. This is the case for acute care, and to an even larger degree for rehabilitation and life after stroke support.
- National and/or regional data is crucial in planning, organising and documenting access to care. However, the majority of European countries lack both the national or regional registries to monitor key information on stroke and the National Stroke Plans to anticipate needs and provide standards for care.
- The burden of stroke is predicted to increase but despite this, most countries do not have a plan for primordial or primary prevention.
“To reduce the burden of stroke, with its grave effects on both individuals and societies, governments must prioritise implementing an adequate organisation of medical and support services through the establishment of National Stroke Plans and setting up national and regional registries to monitor quality, outcomes, and access to stroke care.”
— Prof. Hanne Christensen, Chair of the SAP-E
“This data shows a woeful lack of equitable access to stroke care and support across Europe. This is not good enough. Our governments must do more to prevent stroke, and when they do occur, ensure that every citizen has access to physical and emotional care and support in hospital as well as the ongoing long-term support that each stroke survivor and carer needs when they return home.”
— Arlene Wilkie, Director General of SAFE
Urgent action is needed by each country to implement and fund a national stroke plan that covers the entire chain of stroke care, from prevention and acute care to rehabilitation and long-term support.
Read the full statement
SAP-E Highlights 2022
As we begin 2023 with enthusiasm for the work accomplished and yet to come, we would like to take the opportunity to reflect on the journey we undertook last year.
The SAP-E Steering Committee is pleased to present this round-up of all the activities that took place for SAP-E in 2022.
Read the full newsletter here and sign up here to receive future SAP-E updates right in your inbox.