ESO-EAST “Enhancing and Accelerating Stroke Treatment”

About ESO-EAST

The aim of this ESO project is to offer a 5-year collaboration with selected physicians from Eastern European countries, in order to optimise and implement Stroke Care best practices in their countries and to start a mutual and fruitful collaboration.

Goals

The ESO’s major objective is to improve and optimise the management of stroke in Europe, including the provision of medical education to healthcare professionals and the lay public in Europe, and offering best practice approaches.

ESO projects are targeted to achieve the following purposes:

  • To promote awareness, management, teaching and research in all aspects of stroke;
  • To develop and promote public policies to reduce the number of deaths by stroke and to improve the care of stroke victims and the quality of life of stroke victims.
  • To reduce the global burden of stroke throughout Europe
  • To develop and promote professional and public education;
  • To develop and promote other appropriate activities such as fundraising and prevention programs;
  • To develop, promote, and coordinate international teaching programs through national/regional organisations;
  • To advise and guide on fundraising skills in order to enable national foundations and societies to finance a greater level and range of activities;
  • To foster the development of an international communications system by encouraging the regional activities of organisations, stroke networks, foundations as they operate within the goals and objectives of the organisation.

How to achieve this collaboration?

ESO, supported by independent and unrestricted educational grants from EVER Pharma and Boehringer Ingelheim, will organise a pre-conference whole day workshop before the annual European Stroke Conference (ESOC) in each year from 2015 to 2019.

During the 5-year period, the Stroke Unit Certification committee will be actively involved to create support for the participants in advancing their Stroke Services.

The long term goal of the project is development of 2 types of educational plan. This should include education on stroke treatment, diagnosis and prevention. However, education on research methodology (design, statistics, ethics etc.) is critically important because improvement of stroke management should be evidence based. Education is expected to be conducted in 2 phases. First phase is to provide education to selected KOL experts in each country (if needed). Education will be guaranteed by ESO and will be in English. The second step is the application of knowledge to nation-wide program. Most likely, such education will have to be conducted in Russian or country specific language.

ESO-EAST Steering Committee

  • Robert Mikulik (Brno, Czech Republic), Chair
  • Natan Bornstein (Tel Aviv, Isreal)
  • Valeria Caso (Perugia, Italy)
  • Francesca Romana Pezzela (Rome, Italy)
  • Veronika Svobodova (Brno, Czech Republic)
  • Milan Vosko (Linz, Austria)

Registry of Stroke Care Quality

The ESO-EAST Project is launching RES-Q – the Registry of Stroke Care Quality

The ESO-EAST Project (Enhancing and Accelerating Stroke Treatment) is aimed at improving implementation of stroke treatments in Eastern European countries. Approximately 20 countries participate in the ESO-EAST Project.

The first step for stroke care improvement in these countries is to collect data measuring stroke care quality. The data will be collected for one month every year into newly developed registry called RES-Q (Registry of Stroke Care Quality). Alternatively, national stroke registries or SITS registry could be used. Data based on this registry should serve as a tool for negotiation with local governments to make changes in stroke care.

“We are proud that we officially launched the RES-Q registry at the 2nd annual ESO-EAST Meeting in Barcelona, May 2016. During the last year we developed the technical infrastructure, human network including communication tools and the methodology of data collection. The first data collection is planned in November 2016. Then we plan to collect data each March”, explains Robert Mikulik, ESO-EAST Chair.

Country Representatives of the ESO-EAST Project are coordinating data collection in their countries. Country Representatives will provide promotion material and supportive instructions in local languages to hospitals. All hospitals can register themselves in the RES-Q webpage www.qualityregistry.eu. The platform is very simple, user friendly and will require minimum amount of time to collect data.

Many lectures and workshops are organized in ESO-EAST countries to provide information how to start with the RES-Q and what benefits from RES-Q could be expected. E.g. RES-Q was presented in the 44th Czech and Slovak Stroke Congress in June, in Macedonian Neurology Congress in September, in Workshop on Acute Stroke Treatment in Odessa in September. Many other meetings are planned as in Georgia, in Ukraine and other Eastern European countries as well.

Valeria Caso, ESO President, finds contributing to the RES-Q registry crucial for improving stroke care. “The future of patients is decided by the quality of health care. Therefore the European Stroke Organization, as a professional organization, encourages everyone to participate in stroke care quality monitoring which helps us to improve patient outcomes,” concludes Valeria Caso.

ESO-EAST News

International Day Against Tobacco Use in Kyrgyzstan, ESO-EAST promotion

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International Day Against Tobacco Use in Kyrgyzstan, ESO-EAST promotion

It has been ten years since Kyrgyzstan is celebrating May 31 as ” The Day Against Tobacco Use”. Consumption of cigarettes and other forms of tobacco still is the significant social problem in current time.

On May 31,2016 the event ” Kygyz State Medical Academy (KSMA) is against smoking” was held in Bishkek, Kyrgyzstan. The event was organized by ESO-EAST, Kyrgyzstan, a team of students of Neurological Society of KSMA, Neurology Department and Therapy Department. On intersection of two streets near KSMA students provided educational speeches for random pedestrians about harm of tobacco and hookah use. Speeches were given in English, Kyrgyz and Russian languages and posters presentation as well. All posters were made by hands of students. Pedestrians were able to see threatening pictures on posters imitating lung cancer, stroke and intracerebral bleeding as the consequences of harmful tobacco use. Also, on posters students mentioned the algorithm ”F.A.S.T” for detection of the most acute period of all types of stroke and taught people to recognise stroke as it happens. In addition to the informative part, anyone could identify in themselves stroke risk factors. Special “Station for identification of stroke risk-factors” was organised, where students measured blood pressure, height, weight, BMI and asked smoking history. If they detected any risk-factors, the advice was given to pedestrians how to mitigate these factors and prevent possible strokes. According to the work of station, many people were revealed in a category of high predisposition to strokes: they smoked, had abdominal obesity and high blood pressure, were not following healthy diet. All people in risk received a brochures with “F.A.S.T” algorithm and hypolipidemic diet and were referred to physicians for further treatment prescription.

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After, everyone was able to attend an educational conference, held by senior teachers of KSMA and representatives of WHO, Anti Tobacco Section. The reports were audited: “Do Kyrgyz State Medical Academy students smoke? Results of cross-sectional study  by Dzhilkiarova D., Aralbaeva A.; “Smoking is a risk factor for cerebrovascular disease in the world”  by Lutsenko I.L., National Coordinator of Stroke Registry SITS in Kyrgyzstan and Faculty of Neurology Department. Dr. Lutsenko also introduced  ESO and ESO-EAST to public, encouraged to join collaborative research and apply on all current events.  National Coordinator of Anti Tobacco Committee Chynara Bekbasarova  presented a speech “Results of 10 years of implementation of the WHO guideline against tobacco consumption in Kyrgyzstan and national legislation on tobacco control. Very interesting research data were provided by Kasimova M. “ Experience of  telephone line use for smoking cessation”. She shared result of 5 years work: the helpline is significantly reduces the desire of people for smoking continuation. There were detected a huge number of smokers with a high motivation to quit and advice was given to them. At the end of conference,  KSMA provost, Professor Brimkulov N.N. concluded with speech “By the 10th Anniversary of the adoption of the law, protecting health from negative effects of tobacco use. What have we have achieved”.  After, all students and fellows of ESO-EAST made an Anti-Tobacco march around University campus and also made Anti-Tobacco Zumba flashmob.

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ESO-EAST Kyrgyzstan encourages all neurologists and physicians to join their team and promote knowledge about stroke, its risk-factors and ESO around the world. Watch the video here.

ESO EAST - 6th European Teaching Course on Neurorehabilitation

In the framework of the 6th European Teaching Course of Neurorehabilitation, that took place in Cluj-Napoca, Romania, 1-3 of June, 2016, the ESO East session took place as well. This session was chaired by Professor Natan Bornstein (Israel) and Professor Cristina Tiu (Romania).

In the introduction, Professor Natan Bornstein from Tel-Aviv University, discussed the importance of ESO EAST project as the ESO’s major objective is to improve and optimize the management of stroke in Europe. He emphasized that the aim of this ESO project is to offer 5-year collaboration with selected physicians from Eastern European countries, in order to optimize and implement Stroke Care best practices in their countries.

He also mentioned that ESO, supported by independent and unrestricted educational grants from EVER Pharma and Boehringer Ingelheim will organize a pre-conference whole day workshop before the annual European Stroke Conference (ESOC) in each year from 2015 to 2019 and also that during the 5-year period, the Stroke Unit Certification committee will be actively involved to create support for the participants in advancing their Stroke Services.

Education is expected to be conducted on stroke treatment, diagnosis and prevention and will be accomplished in two steps. First step is to provide education to selected KOL experts in each country (if needed). This will be guaranteed by ESO and will be in English. The second step will be the application of knowledge to nation-wide program and such education will have to be conducted in each country specific language. In April 2015, the first meeting of ESO EAST collaborators took place at the ESOC in Glasgow.

In a second talk on the national stroke registry, Professor Bornstein pointed out the important role of clinical registries in measuring healthcare delivery and supporting quality improvement for individuals with cardiovascular disease and stroke. Professor Bornstein mentioned that the focus of clinical registries is to capture data that reflect “real-world” clinical practice in large patient populations and the data will not replace the need for traditional randomized controlled trials, but registries and trials are complementary approaches, each with unique advantages and imperfections. Clinical registries also provide the opportunity to identify and evaluate healthcare disparities within a broad patient population in community practice outside of the structured research protocol setting. This promotes the ability to examine important issues involving patient access and outcomes in subpopulations, including racial and ethnic minorities, women, the elderly, individuals with multiple comorbidities, and individuals with congenital heart conditions.

Professor Cristina Tiu from the University of Medicine and Pharmacy ”Carol Davila” Bucharest, Romania, presented the current status of the Romanian National Stroke Registry. According to Professor Tiu, even though Romania has not yet developed a registry of stroke cases, in the past 10 years there have been made important steps towards its realization. At the moment in Romania there are 10 stroke units in the main university centers and the objective is to ensure future facilities for such centers in all major hospitals in the country. Four of these centers are located in Bucharest and the others in Iasi, Tg. Mures, Cluj-Napoca, Timisoara, Oradea, Suceava. The importance of these stroke units was emphasized, not only to achieve i.v. thrombolysis or thrombectomy but also for a standardized care according to the guidelines and early neurorehabilitation for all patients with acute stroke. A brief review of the main data collected in the Romanian Registry of Thrombolysis (464 cases in the last 3 years) under the coordination of Professor Ovidiu Bajenaru was presented, with comparisons of the national results with results from the main international trials. These results were also presented this year, in the EAN Meeting in Copenhagen, as a poster (P1222; Cerebrovascular Diseases section). Professor Tiu also presented the main achievements within ESO East Projects such as participation in 2015 of 23 neurologists from various regions of the country in the 2 weeks training “Organization and functioning of stroke units“ which was held in Bucharest and, in February, and of one nurse and one physician in the ESO EAST Stroke Unit Nurse Education Project in Kiev, in March 2016. Regarding the plans for 2017 Cristina Tiu mentioned the organizing of a teaching course of ultrasonography, training courses for stroke unit nurses, including the SAH (subarachnoid hemorrhage) cases in a section of the National Registry and also an extended evaluation of the 21 quality indicators in all centers involved in thrombolysis.

Dr. Daniela Efremova presented on behalf of Professor Stanislav Groppa from “N. Testemitanu” State Medical and Pharmaceutical University, Republic of Moldova the stroke peculiarities in Moldova’s population. Regarding the incidence and prevalence in stroke in the Republic of Moldova, during the years 2000-2014 there was a progressive increase of cerebrovascular diseases reported per 10,000 population, the incidence increased from 20.4 in 2000 to 26.82 in 2014, and the prevalence from 67.0 in 2000 to 199.08 in 2014. The death rate from stroke in Republic of Moldova remains one of the highest in Europe. According to Stanislav Groppa, knowledge about specific risk factors for stroke in the population will contribute to develop a national strategy for primary prevention of stroke.

This presentation also highlighted the results of an epidemiological study conducted in Moldova over a period of 3 months, between October and December 2015, and aimed to identify the prevalence of the risk factors for stroke in the Republic of Moldova. The results of the study showed that the main risk factors for stroke were obesity in 46% of the cases, overweight in 33% and also hypertension in 44% of the cases. Most of the strokes cases were ischemic and presented type I and II of atherosclerotic plaque of ACI at Doppler-Duplex analysis.

Professor Vitalie Lisnic from the Republic of Moldova presented the current status and future developments of the Moldavian Stroke Registry. As Professor Lisnic mentioned, the Moldavian Registry started to be developed before ESO EAST Project, in 2005, and it has been connected to the National Medical Statistics Registry. Currently, the cases are registered in two stroke units from Chisinau, most of them in the Institute of Neurology and Neurosurgery under the coordination of Professor Groppa. Regarding the activities of ESO EAST Project accomplished so far, Professor Lisnic highlighted the establishment of a team of neurologists within the Neuro-emergency Department and Stroke Unit of the Institute of Neurology and Neurosurgery responsible for elaboration and implementation of the stroke registry, the elaboration of a form for data collection, the data already collected for July-September 2015, the presentation of ESO EAST activities within national congress in 2015 and, starting with 1st of April 2016 , introduction of the data into SITS. For 2016 the Moldavian ESO EAST activities include the introduction of all stroke patients in SITS at the Institute of Neurology, a more active collaboration with Institute of Emergency Medicine, participation in national congress and organizing of the Day of the European Academy of Neurology.

In the closing session of this important European educational event, Professor Dafin Muresanu mentioned that the ESO-EAST project was received with interest and the audience appreciated the opportunity to follow the activities within the project on the website of ESO. This educational platform will be useful for all neurologists involved in the field of cerebrovascular disorders and will contribute to increase the quality of stroke care in the Eastern European Countries.

ESO-EAST Workshops

ESO-EAST Workshop 2016

2nd ANNUAL ESO EAST WORKSHOP – BARCELONA, 9 May 2016
CCIB – Centre Convencions Internacional de Barcelona, Hall H Room 118 + 119

PROGRAMME

8.30 – 8.45    INTRODUCTION (welcome speech, intro of ESO-EAST Project)     Valeria Caso    Robert Mikulik
8.45 – 9.15    WHO Opening Lecture    Jill Farrington
9.15 – 9.40    Global Burden of Disease.  Stroke app.    Valery Feigin
9.40 – 9.55    ESO EAST PROJECT UP-DATE: summary of outputs 2015/16   Veronika Svobodova
9.55 – 10.10    ESO EAST PROJECT UP-DATE: summary of results: Robert Mikulik    Natan Bornstein
10.10 – 10.25    Coffee break
10.25 – 11.30    ESO EAST PROJECT UP-DATE part A: Results from 10 countries Each country representative
11.30 – 11.50    Coffee break
11.50 – 12.55    ESO EAST PROJECT UP-DATE part B: Results from 10 countries Each country representative
12.55 – 13.30    Lunch
13.30 – 13.45    Performance measures for endovascular treatment, logistics, target times    Adam Kobayashi    Valeria Caso
13.45 – 14.15
IMPACT OF REGISTRIES ON STROKE CARE
1.    Impact of Israeli registry on stroke care  Natan Bornstein
2.    Impact of SITS on stroke care in the Czech Republic  Robert Mikulik
3.    Impact of Quick registry on stroke care in Poland  Maciej Newada
14.15 – 14.45    Education for Nurses – status quo, next steps, discussion     Yuriy Flomin
14.45 – 15.15    Coffee break
15.15 – 15.30    Funding for healthcare and research    Veronika Svobodova
15.30 – 16.30    Summary of challenges and action plan    Robert Mikulik, Valeria Caso, Natan Bornstein
16.30 – 16.45     Closure     Robert Mikulik
18:00    Delegate Speaker Networking Dinner    Invited Delegates and Speakers

Funding:
The ESO EAST Project is supported by unrestricted grant from EVER Pharma and Boehringer Ingelheim companies.
The ESO EAST Meeting in Barcelona is also supported by St. Anne’s University Hospital Brno, Czech Republic, by grant ICRC-ERA-HumanBridge No. 316345 funded from the European Union’s Seventh Framework Programme for research, technological development and demonstration.

Prepared by Veronika Svobodova

ESO-EAST Workshop 2015

ESO EAST “Enhancing and Accelerating Stroke Treatment” Workshop 2015
Sponsored by EVER Pharma and Boehringer Ingelheim
Crowne Plaza Hotel, Glasgow, UK
16 April, 2015, 8:30 – 18:00

8:30 – 9:00     Arrival and Welcome
– coffee, tea and cookies –

9:00 – 9:20     Official Opening of the Workshop
–    Kennedy Lees, President,  Valeria Caso, President Elect, Robert Mikulik, Co-Opted Board Member at Large, Nikolay Shamalov, Chair of ESO-EAST

9:20- 9:30        Introduction of Delegates

Moderators: Robert Mikulik and Nikolay Shamalov

9:30-10:00     Tackling stroke in a developing country – what to do first (the Georgian example)  – Alexander Tsiskaridze

10:00-10:30     In hospital stroke care and basic stroke care quality indicators: specific treatment, early prevention, dysphagia, temperature, and hypertension, nursing strategies – Francesca R. Pezzella

10:30-11:00     What we have learned from National registers? The Israeli model: How to design a stroke registry (and what it can achieve?) – Natan Bornstein

11:00-11:30        Morning Coffee Break

Moderators: Alexander Tsiskaridze and Francesca R. Pezzella

11:30-12:00     SITS-EAST- how registry helped to improve stroke care in the Czech Republic – Robert Mikulik

12:00-12:30     Stroke network in the Russian Federation  – Nikolay Shamalov

12:30-13:30         LUNCH

Moderators: Natan Bornstein and Milan R. Vosko

13:30-14:00     How to promote the concept of Stroke Unit? – Milan R. Vosko

14:00-14:30     Stroke epidemiology in Eastern European Countries and Russia – what we know and do not know  -Valery Feigin

14:30-15:00                  Afternoon Coffee Break

Moderators: Natan Bornstein and Robert Mikulik

15:00-17:45      How to Improve Stroke Care in Your Home Country
Work in facilitated groups. Short presentations will be prepared according to template during this session and presented. Discussion and plans for the next year.

17:45-18:00    Closing Remarks – Robert Mikulik

18:30        Networking Dinner Reception (off site)

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