The lack of care for stroke survivors comes at a great cost

Most European countries lack a plan for how to care for stroke survivors, missing out on an opportunity to ease a big burden weighing on already stretched health systems.

A stroke happens when the blood supply to the brain is blocked, damaging brain tissue. According to the Stroke Alliance for Europe (SAFE), more than 750,000 people in Europe experience this life-threatening condition every year – a number that is projected to increase by 35% between 2017 and 2050.

Stroke can have long-lasting effects on a person’s health and well-being, such as a disability due to brain damage. Stroke survivors also risk having a second stroke or experiencing another health emergency, such as heart failure.

It is in the aftermath of the first stroke that most European countries fail to ensure proper care pathways for survivors, which can have an enormous impact on their lives as they often struggle to return to working life, according to SAFE and the European Stroke Organisation (ESO).

SAFE and ESO spearheaded a Stroke Action Plan for Europe, launched in 2018, which aims to encourage all countries to have a fully comprehensive funded national stroke plan, ranging from primary prevention to a programme for life after stroke.

The director general of SAFE, Arlene Wilkie, told Euractiv that many countries are doing well in terms of awareness-raising prevention campaigns and acute care, but struggle to take into account post-stroke care, which should cover an extensive range of support such as psychological support, occupational therapy, social care, housing, and getting back to work.

“After leaving the hospital, it just becomes a much more complex situation,” Wilkie said.

“All these things are individual components and they’re not all well linked together,” she continued, adding that most people report leaving the hospital “to nothing”.

The lack of “integrated care pathways”, as they are called, for stroke survivors across Europe results in huge added costs to societies, on top of the costs stemming from acute hospital care.

Wilkie argued that “the economic costs of not doing something for stroke is likely more than governments would spend on doing something for stroke”, however, a lack of data about people’s lives after stroke makes it difficult to calculate the actual economic costs.

European initiatives

Concrete action on stroke and setting up integrated care pathways is a responsibility that lies with the individual EU countries.

However, on the EU level, the European Commission launched the EU Non-communicable Diseases (NCD) initiative in 2021. Stroke is included in the initiative, which suggests “improving integrated care and rehab pathways for stroke patients”.

According to a Commission spokesperson, the NCD initiative overall helps countries with similar challenges or solutions to implement “best practices and ambitious policies.”

“In fact, joint collaborative work between the Member States is essential in this regard. This can include measures to improve the lives of stroke patients post-stroke,” the spokesperson told Euractiv.

Tudor Ciuhodaru, a socialist MEP in the European Parliament’s health and environment committee and its public health subcommittee, who previously worked as an emergency physician, believes the NCD initiative is good step, but thinks even more can be done from the EU side to support member states care for stoke survivors.

He believes it would be beneficial to encourage post-stroke offices at the European level, set up by the member states to help patients navigate the system post-stroke.

“These offices [would] basically provide all the necessary assistance for the post-stroke patient in one place, and also provide further direction and therapeutic evaluation. Thus, the intervention time is reduced and the results of the therapeutic approach are maximised,” Ciuhodaru told Euractiv.

Support from different sides

According to Wilkie, it is too early to tell what impact the EU NCD initiative will have. She voiced hope, however, for more recognition of the issues as the work with the NCD initiative moves forward.

Certain parts of the EU NCD initiative focused on stroke build on the Stroke Action Plan for Europe. With an emphasis on national plans covering stroke from prevention to post-stroke care coming from both the EU and grassroots level, Wilkie hopes governments will soon make it a higher priority.

“The hope is that this will ultimately raise a priority and importance onto stroke and to the member states, who will then look to develop national stroke plans in their countries,” she said.

[Edited by Giedrė Peseckytė/Zoran Radosavljevic]

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