Newsletter

ESO Newsletter

As the voice of stroke in Europe, ESO strives to maintain an open line of communication with its members. A monthly newsletter containing updates on ESO activities and stroke related news is distributed to all ESO members and published here.

We encourage article submissions from members. To submit an article for publication in an upcoming newsletter, please contact Jennifer Thomsen.

October 2016

President`s Letter

President’s Letter

Dear Friends and Colleagues,

The 2016 Word Stroke Day theme is “Face the Facts: Stroke is Treatable”, highlighting the importance of decisions made in the stroke care chain, from ambulance to ER to Stroke Unit.

This theme contains two messages:  firstly, persons need to be made better able to recognize stroke symptoms and understand the importance of immediately seeking dedicated care. Current campaigns that have successfully focused on these issues include the  “FAST” campaign in the UK and the “RAPID” campaign in Catalonia http://www.fundacioictus.com/.  Additionally, a stroke code that prioritizes hyperacute stroke patients with a hospital pre- alert needs to more widely adopted as it has shown to significantly reduce the onset-to-door time.  As well, in-hospital codified stroke pathways for reducing intra-hospital delays need to be uniformly adopted for the proven better outcomes that they lead to. In fact, Atte Meretoja et al., in his 2014 Stroke   article “Save a Minute, Save a Day” has demonstrated that reducing door-to-needle time (DNT) for thrombolysis leads to improved outcome for all stroke patients.  While the “Golden Hour” has been recommended for DNT, several institutions have been able to achieve average DNTs of 10minutes  (Roine Risto, Division of Clinical Neurosciences Turku University Central Hospital) and 23 minutes (Hanne Christensen, Department of Neurology Bispebjerg Hospital & University of Copenhagen) in Europe.

Secondly, due to the increasing number of effective treatment options which are presently available, the once nihilist view towards stroke is being replaced by a view of encouraging  optimism. I would like to  share with  younger stroke physicians  my first   experience in “treating”  a  stroke patient over 20  years  ago  at  the Neurology Clinic in  Perugia. The senior consultant at the time highlighted the fact that this was not an emergency by stating   “It is a stroke, you can do nothing”.  This was long before the ” time is brain”  concept that rules  our  clinical practice today. How things have changed  for the better!

To learn more about the  2016 World Stroke Campaign you can go to: http://www.worldstrokecampaign.org/about-the-world-stroke-campaign.html.

Despite these successes, the Global Burden of Disease (GBD) 2013 study reported a significant worldwide increase in stroke burden between 1990 and 2013:  with annually  almost 6.5 million deaths from stroke, 113 million Disability-Adjusted Life Years (DALYs) lost due to stroke and 10.3 million of people with new strokes.

These numbers reflect that  stroke prevention and acute care standards are not being  uniformly  applied throughout Europe. In fact, Central and Eastern Europe stroke incidence and mortality rates tend to be higher and  stroke onset is on average 10-15 years earlier, compared to Western Europe.

To address this, the ESO EAST-group is actively collaborating with WHO, on the Global Action Plan for 2013-2020, to reduce the number of premature deaths from NCDs by 25% by 2025 [Global Action plan, 2013].

The ESO-East Steering Committee  Member Francesca R. Pezzella (San Camillo Forlanni Hospital, Rome) has travelled with WHO representatives to  Kazakhstan, Byelorussia and Kyrgyzstan  in order to understand where ESO could  best support  stroke health care professionals and patients has travelled with WHO representatives to  Kazakhstan, Byelorussia and Kyrgyzstan.

In this newsletter you will find information on diverse  stroke  education  campaigns. Personally, I was very impressed on what is going on our member countries. The commitment of our  committee  members  and  directors  over the last 9 years  has  allowed  ESO to  reach  unimaginable goals.  As your President, my goal is only  one –  to  set  and reach  even more ambitious  objectives for the future,  together with  you,  our ESO Members.

 

Sincerely Yours,

Valeria Caso, ESO President

Interview with Prof. Valery Feigin

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Interview with Prof. Valery Feigin

National Institute for Stroke and Applied Neurosciences,

Auckland University of Technology, New Zealand


 How would you estimate the actual level of stroke risk factors control worldwide? Would you identify specific causes that prevent an optimal risk factors control?

The increased level of virtually all major risk factors for stroke across most countries speaks  for itself – the actual level of stroke risk factors control worldwide is unsatisfactory. Apart from epidemiologic transition and associated greater exposure to  unhealthy diet (e.g. fast food), smoking and low physical activity experienced in many low to middle-income countries (75% of the world population), there are a number of other causes likely to be responsible for the poor control of the risk factors. The first one is a very low awareness of the general population about stroke. The majority of people (even in developed countries) cannot identify any of the stroke symptoms and many  cannot identify a single risk factor for stroke. The fact that for over 30 years stroke was classified in the ICD-10 under the category of cardiovascular disease also contributed to the low awareness of the general population about stroke. Many people (even in developed countries) associate stroke with heart disease, and not the brain! The other very important causes of poor control of risk factors are the very low implementation of population-wide primary prevention strategies into practice and emphasis on high-risk prevention strategies. There is still no country in the world where population-wide primary prevention strategies are implemented in full on a country level. In 2008, Prof. Simon Capewell (UK) argued that the greatest danger arising from the high-risk approach is that it is ”misleading professionals, planners and politicians into thinking they can tick the mission accomplished box for preventing cardiovascular disease”. The lack of use of  population-wide prevention strategies, and unreasonably excessive focus on high-risk strategies, proven ineffective on a population level prevention,  have been suggested as the main reasons for insufficient efficiency of the currently used primary stroke/CVD prevention.

 

In your opinion, what would be the most effective in translating the efforts of the scientific community into results? Is it a communication issue?

In terms of primary stroke prevention, the lack of effective communication between academics and health-care policymakers is one of the main reasons for poor translation of evidence-based interventions into practice. The other very important reason for the unexceptably low translation of evidence into practice is the lack of funding and goverment support. Everyone agrees that primary prevention is important but what we are lacking are actions, which are based on evidence, and culturally appropriate. We are also lacking  translational research, which is shown to be a very important component of implementing evidence into practice. A good example of such practice is seen in Canada, where translational research is a mandatory part of all relevant grant applications.


 

 

What is the role of education in risk factors control and stroke prevention? Do you see an active role of schools in stroke prevention? Any suggestions for a strategy program in schools?

The role of education in risk factors control for stroke (and other major non-communicable disorders) prevention is difficult to estimate. In our recent (2016) Nature Neurology Reviews paper we emphasised that maternal health and lifestyle, normal birth weight, and adequate nutrition from the first days of life are important determinants of health, including risk of stroke and other major non-communicable disorders later in life. Healthy lifestyle habits, adequate physical activity and maintenance of a healthy weight should be established at a young age, reinforced throughout the lifespan (for healthy diet habits, probably during the first year of life), and could be successfully incorporated in preschool, school, day-care and other interventions in early-life settings.

 

What do you consider to be the role for other modifiable risk factors like COPD (Chronic Obstructive Pulmonary Disease), known to raise stroke risk both in smoker and non-smoker patients, probably through continuous low grade systemic inflammation ?

Different causes of systemic inflammation and chronic infections (including COPD) have been shown to be very important risk factors for stroke and many other non-communicable disorders, including dementia. It is also known that infections can trigger stroke. The exact mechanism of such associations is still under investigation but the role systemic inflammation and chronic infarction plays in blood coagulability and atherosclerosis has been reasonably well established.

 

Smoking quitting strategies failure has, probably, more than one explanation. Do you think that seeking  individual reasons for smoking quitting failure could help in obtaining better results?

Smoking remains one of the most important risk factors for stroke, particularly for ischaemic stroke and subarachnoid haemorrhage. Unfortunately, a substantial proportion of smokers who have stopped smoking for some time soon resume smoking. The reasons for that may be multiple. I think that identifying the reason, using the appropriate evidence-based smoking cessation strategy most suitable for the person and motivating the person are important in improving sustainability of the smoking cessation.

 

Please, tell us about the potential of the stroke Riskometer in stroke prevention.

We, and many international experts, believe that the Stroke Riskometer app can bridge the existing gap between population-wide and high-risk prevention strategies and substantially improve primary stroke prevention. As the fully validated predictive tool endorsed by the World Stroke Organization, World Federation of Neurology, World Heart Federation and European Stroke Organisation and many national stroke organisations, the app provides targeted advice to enable and motivate a person to recognise and control their risk factors, as well as educating them about the warning signs of stroke, and measuring the effectiveness of stroke prevention. We believe that the app should be incorporated into the health system and used by both health professionals and lay people as widely as possible.

 

 

The RIBURST study is expected to be a huge worldwide study with a real impact on stroke prevention strategies as well as on other non-communicable diseases management.  Could you please tell us more?

There are currently over 300 experts from 102 countries involved in the RIBURST study, already making it  one of the largest epidemiological studies in the world. At the first stage of the study (cross-sectional study), which is underway,  we already have about 7000 study participants and many more coming every month. We will collect much needed prevalence data on risk factors and health conditions (including heart disease, dementia, cognitive impairment, diabetes mellitus, traumatic brain injury). This study will continue for another 2-3 years, and we plan to enroll several hundreds (if not millions) of study participants. After completion of this study we will follow-up all study participants for 2-3 years (second stage of the RIBURST study) for health outcomes, including stroke/TIA, heart disease, dementia, cognitive impairment and diabetes mellitus, effectively conducting a prospective cohort study. After completion of this stage of the RIBURST study we will develop new, population-specific (country-specific) algorithms for predicting stroke/TIA, heart disease, dementia, cognitive impairment and diabetes mellitus (third stage of the RIBURST study), and then we will  develop country-specific apps for primary prevention of stroke/TIA, heart disease, dementia, cognitive impairment and diabetes mellitus. At the fourth and final stage of the RIBURST study we will be testing those apps in randomised clinical trials in selected countries followed by support for their implementation into practice. It is a 10-year, very ambitious programme but with the huge national and international support we already have, and continue to receive, we hope we will succeed. We are already testing the Stroke Riskometer app in a randomised controlled trial in New Zealand, and the preliminary results are very promising. Should the app and the whole RIBURST programme be successful, the wide use of the apps could save millions of lives and billions of dollars around the world.

 

Interview with a Stroke Survivor

Interview with a Stroke Survivor: Sanja Stanojevic

36 years old, Skopje, Macedonia

Sanja had a stroke one year ago, when she was hospitalized at the University Clinic of Neurology in Skopje, Macedonia, due to cerebral venous thrombosis with haemorrhagic transformation. She was soporous, with hemiplegia and symptomatic seizures. She also developed pulmonary thromboembolism and deep crural venous thrombosis. Later, antiphospholipid syndrome and patent foramen ovale were discovered and treated. One year later, Sanja is talking about her personal experience with stroke. Prof. Dr. Anita Arsovska (treating physician of Sanja), carried out the interview, asking the following questions:

Tell us about your stroke, when did it happen and how did you feel?

I have had a stroke last summer in 2015, i.e. on the 29th of June, when I was 35 years old. Basically, I thought that I was a relatively healthy person, or so I thought until May last year, when I started to feel toothache (in all teeth). I felt constantly tired, without any special reason, I started losing weight, had tachycardia, constant thurst…Until then, I was physically active, but gradually became passive and constantly laying in bed. Two days before the stroke I started to vomit. I did not eat, but constantly vomited, had immense pain in the whole body, my lungs hurt, I had vertigo, photophobia, any movement bothered me…I am a person that has a high level of pain tolerance, but this was too much, even for me. The day, actually, the evening that I had a stroke, the last thing that I remember is that I had difficulty falling asleep, hoping that when I wake up I would be better, but, unfortunately, I was not. And I must say that that is all I remember before the stroke. My next awakening was in the hospital (University Clinic of Neurology).

What is your first memory when you woke up?

My first awakening was very traumatic for me. I saw people in white coats around me and somehow I realized that I am in a hospital, but I did not understand why. The nurse tried to prevent me from removing the devices that were attached to me. I remember my husband as the first familiar face and I tried to call him to enter the room, however, I was not able to speak for days. I also remember that I had a very vivid dream that involved my family and friends, and when I woke up, I could not distinguish whether that was a reality or just a dream.

What problems did you encounter after stroke?

After stroke, I thought that I could speak, however, this was not the reality. I tried to ask many things, but I received “strange” answers. It felt odd, and I promptly forgot what I had been told. Due to my disease I could not move (I did not now it), and when I discovered it with my physiotherapist, it was a terrifying moment.I have had moments of depression, but this moment was really important and somehow “knocked me down”. The medical personnel took me constantly to different diagnostic investigations that were “strange” for me and it was difficult for me to understand why all these procedures were done for me. This is how I felt during my hospitalization, and when I returned home, I was scared of what was going to happen. My body changed from outside and from inside. Most changes I felt on the right side. I had paresthesiae on the arm, leg, head, I could not function normally with my right side. I had occasional swallowing on the left leg. Today I use medical sock for my left leg. I still have a strange feeling on my right side when the weather changes.

Who helped you the most after the stroke?

From the medical aspect, the whole medical staff at the Department for urgent neurology at the University clinic of Neurology helped me the most and for that I shall be grateful for my whole life. From personal aspect, my husband, my family and the physiotherapist helped me the most.

Who supports you the most?

The biggest support for my treatment and rehabilitation comes from my husband and my closest family.  

What is your current job?

The first months after I left the hospital were pretty stressful for me, however, due to my persistence and wish for faster recovery, I gradually started to “come back” as I used to be. Nowadays I have returned to my job (only part-time), but it is still something, don’t you think? I take my medications regularly and go to medical check-ups.

What represents challenge for you in your life?

I must admit that every new day is a challenge for me because I learn new things for me and for my organism.  Every years’ season is different for me compared to previous years. Sometimes I feel pain, sometimes I feel depressed when I think of what has happened to me. I still ask my closest family, especially mu husband what happened to me when I was in coma for 10 days, but sometimes I do not like to hear the answers. I fight every day and everybody that knows me will tell you that I am a fighter; although many things happened in my life, I always try to see the brighter side because I love my life!

 What type of advice could you give to individuals with stroke and their families?

My advice is that they try to understand what has happened and then try to accept that the stroke happened exactly to them. I think that it will make easier for them to face with consequences of stroke. This is not easy, however, with a great will of the patient and support from the family, the stroke survivor can enter a phase of rehabilitation. It is not simple, a lot of patience is needed and courage! We are alive! Thank God and the medical staff for that.

 What would you tell the medical staff (physicians, nurses)?

I would recommend to have more patience. I know that they have a lot of duties and a lot of patients, however, their reactions have a great influence on us. Due to the specificity of this disease, we, the patients are sometimes tiresome, but we need the doctors and the nurses because we feel helpless. As far as my treating physician and her team is concerned, I am very happy and satisfied with Prof. Dr. Anita Arsovska.

 How do you see yourself in the future?

In the future, I would like to be that “old” Sanja, to feel less consequences of what happened to me in the summer of 2015, to take less medications (or no medications at all) and I would like that summer of 2015 never happens again. Most of all I would like to be healthy and alive, fulfilled privately and professionally.

 

 

Stroke is Treatable – World Stroke Day Activities in Europe

World Stroke Day Activities in Europe Macedonia, Serbia, Slovenia, Croatia, Italy

World Stroke Day is 29 October. This year`s motto is Stroke is Treatable. The World Stroke Organization has prepared a tool kit of resources to raise awareness. The ESO supports and encourages recognition of World Stroke Day. We have compiled a list of activities taking place in Europe under this theme Stroke is Treatable and encourage all members to participate in local events.

Read about national activities in Macedonia, Serbia, Slovenia and Croatia, Italy

Stroke Awareness and Prevention Promotion

Stroke Awareness and Prevention Promotion Resources from ALT

It is important to educate on preventive strategies, lifestyle change and the early identification of stroke symptoms. ALT-Association against Thrombosis and cardiovascular disease-Onlus, Italy have been working to bring awareness to stroke risks and prevention. Watch and share the English educational videos.

Resources from ALT

ESO Department to Department Visit Programme 2016

ESO Department to Department Visit Programme 2016

The ESO Department to Department programme is offered to young physicians and scientists to support a short visit to a European department or laboratory. One of the 2016 grantees, Loes Rutten-Jacobs visited the Institute for Stroke and Dementia (ISD) research in Munich.

Read the report

For more information on and to apply for the 2017 ESO Department to Department Visit Programme

September 2016

President`s Letter

President’s Letter

Dear Friends and Colleagues,

It is my pleasure here to provide you with an update on the numerous ESO activities that are being carried out by our members. My role as president is to be a facilitator of these activities that work toward achieving the declared aims of the society. Promoting the adherence to ESO guidelines is the declared mission of ESO. Therefore, guaranteeing the relevance of these guidelines is of utmost importance. For this, the Guideline Committee Chairs, Thorsten Steiner and George Ntaios along with the Executive Committee have involved Peter Langhorne and Hazel Fraser, the Coordinating Editor and Managing Editor, respectively, of the Cochrane Stroke Group, to hire a qualified person who is able to develop and execute complex and comprehensive systematic literature searches, as well be expert in using the GRADE Profiler software system (as described in the SOP wso.sagepub.com/content/10/SA100/128.full.pdf+html). The link for this job application can be found here: www.dcn.ed.ac.uk/csrg/vacancy/

This support person is needed to respond to the issues surrounding the changes that are underway in the collection of data. A candidate would need to possess a strong background in research-related materials and excellent communication skills so to provide multi-level support to the ESO working groups during the development of ESO Guideline documents.

Another activity is the upcoming ESO-Karolinska Stroke Update Conference where stroke therapy research will be presented. Attendees will have the opportunity to express their opinions on how the findings presented from this research can improve clinical practice and impact current guidelines www.eso-karolinska.org/2016/.

The Executive Committee has agreed to endorse “The European Angels Initiative”, which was recently launched by Boehringer Ingelheim. This initiative aims at developing a community of at least 1,500 stroke centres and stroke-ready hospitals across Europe by May 2019. As ESO’s mission is to foster greater adherence to its current guidelines throughout Europe, ESO fully shares the declared objectives outlined in the Angels Project. In recognition of this, ESO has granted the initiative the use of the ESO logo for the following activities on a 6-month renewable basis: The Nurse Education Project (on the condition that it remains in line with aims set out by the German Stroke Society and ESO), The Angels Academy (on the condition that the teaching content can be accepted by the ESO Education Committee), The Angels Awards (on the condition that ESO is in charge of selecting the beneficiaries) and The Angels Young Neurologist Fellowship Program (on the condition that selection decisions be accepted by the ESO Young Stroke Physicians Committee). Your participation is encouraged. Please contact your national coordinator to find out how you can get involved angels-initiative.com

ESO has requested that Boehringer Ingelheim solicit for additional sponsors for the Angels Initiative to assure its long-term non-proprietary aims. The Angels Initiative is legally registered for the support of healthcare and does not constitute an inducement to recommend, prescribe, purchase, supply, sell or administer specific medicinal products. This complies with Section 11.1 of Article 11 of the EFPIA HCP Code as approved by the General Assembly of 6 June 2014.

Our website is about to get a new look. Together with our head-office and the PR committee chaired by Paola Santalucia, we are working on bringing you a website that is easier to read and use. The website will continue to offer employment opportunities http://eso-stroke.org/career/, provide updates on ESO-EAST activities www.eso-stroke.org/eso-stroke/esoeast/about-eso-east-project.html and news regarding ESOC 2017 www.esoc2017.com

Finally, the ESO PR Committee has been recently flanked with a Social Network Committee, which will be chaired by Milan Vosko. This new committee is connected to LinkedIn, Twitter and Facebook. We invite you to post here any news you might have from your country regarding stroke care strategies (both problems and solutions), insights and of course any thoughts on how ESO can better respond to your professional needs.

I thank you for your commitment to ESO’s activities that strive at guaranteeing access to stroke care for all stroke patients throughout Europe based on current ESO Guidelines

Sincerely Yours,

Valeria Caso, ESO President

4th ESO Guideline Development Workshop Scheduled

4th ESO Guideline Development Workshop Scheduled

ESO invites its members to participate in the 4th Workshop about ESO Guidelines Development – formerly called GRADE Workshop. The workshop will take place in Stockholm, SE on Sunday, 13.11.2016, preceding the ESO-Karolinska Stroke Update Meeting.
For more information and to participate in the 4th ESO Guideline Workshop, download the flyer.

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

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

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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 2ndannual 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.

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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 as a 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.

Veronika Svobodova
ESO-EAST Manager
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The ESO-EAST Project Management Board has new members

We are very happy that two more colleagues Dr. Francesca Romana Pezzella from Italy and Dr. Milan Vosko from Austria have become a part of The ESO-EAST Management Board. Both colleagues are active in Social Media Working Group, which is subgroup of ESO PR Committee, and are experienced in stroke projects. Francesca Pezzella will be responsible for communication with WHO and Milan Vosko helps us namely with Public Relations and internal communication. We are looking forward to cooperation with both of them.

On behalf of the ESO-EAST Management Board
Veronika Svobodova
ESO-EAST Manager
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4th ESO–ESMINT–ESNR Stroke Winter School Applications Accepted

4th ESO–ESMINT–ESNR Stroke Winter School Applications Accepted

The deadline for applications to participate in the 2017 Stroke Winter School in Berne, CH is 31. October 2016.
Young stroke physicians and neuroradiologists with a major interest in cerebrovascular diseases are encouraged to apply. The primary goal of the ESO–ESMINT–ESNR winter school on acute interdisciplinary stroke treatment is to join young stroke physicians and young neuroradiologists in order to enhance interdisciplinary management of patients with acute ischaemic stroke. There will be joint sessions for neuroradiologists and stroke physicians in the morning. In the afternoon there will be special courses for stroke physicians and “hands-on” courses for interventional neuroradiologists. Teachers will be local, national and international experts in their fields.

For more information and application instructions download the brochure.

ESO Stroke Summer School Announces Hosts 2018-2020

ESO Stroke Summer School Announces Hosts 2018-2020

The ESO Stroke Summer School is a flagship event for ESO and a prestigious educational meeting for stroke trainees throughout Europe. We are pleased to report that following the recent call to all ESO members, we received several high quality applications to host the ESO Stroke Summer School 2018. Three applications were judged to be of an excellent standard, following evaluation by the ESO Education Committee and approval by the ESO Executive.

Since all three bids were of such a high standard, we are delighted to be able to award the Summer School host locations for the next three years (2018-2020) as follows:

2018 Berlin, Germany

2019 Helsinki, Finland

2020 Caen, France

We are confident that these hosts will maintain the very high standard set by previous ESO Summer Schools.

Together Against Stroke: SAFE, ESO and the Industry

The Meeting between SAFE, ESO and the Industry

London, 13th September 2016– For too long the approach to raising the issues around stroke care has been fragmented. Commercial, patient and professional voices are often involved in separate campaigns leading to noise in the system that decision makers have all too easily been able to ignore. For this reason, on September 13th, Stroke Alliance for Europe European invited Stroke Organisation to host together a meeting with numerous representatives of the industry and communication agencies in the Stroke Association House, London.

Apart from SAFE’s representatives and ESO Vice-President the meeting was also attended by representatives from the following companies (in alphabetical order): Allergan, Bayer, Boehringer Ingelheim, Daichi Sankyo, Medtronic, Merz, Penumbra and Pfizer/BMS, and by PR and advocacy agencies Cohn & Wolfe, Gplus Europe and Weber Shandwick.

The main purpose of the meeting was the introduction of the Burden of Stroke Report coming up next year.

The report is a part of research that will provide insights on the position regarding stroke care across the countries of Europe. It is expected that this report should enable benchmarking of provision in one state compared to another. Along similar timelines, ESO has an on-going research concerning trombectomy and acute care in Europe, launching a Survey at European level.

Both SAFE and ESO are coordinating to achieve a joint launch of mutual findings in European Stroke Awareness Month May 2017.

Jon Barrick, the President of SAFE stated that the immediate plan is to launch the Report at the EU in the week preceding the ESO European Stroke Congress which is the 16th to 18th May in Prague. This topic will receive further coverage at the ESO Congress in form of academic papers.

Sponsors of the Burden of Stroke Report will be involved in both the discussion of its findings and the formulation of recommendations, as well as participation in the EU and country launches. The next immediate point is to explore strategic planning of this sort of work for the following three years.

Discussion with Commercial and Professional stroke care partners has led us to the conclusion that a mutual exchange of information regarding how to raise the profile of stroke care and stroke as a cause would be beneficial, including details of timetables for activity.

From ESO and SAFE’s point of view we want to create the opportunity for evidence based policy making around stroke to be driven in a more coordinated and meaningful way, and to that end want to start a discussion, and be open, about patient and professional stroke care driven hopes and our willingness to work collaboratively to achieve better education, awareness and quality of stroke care.

In conclusion, Jon Barrick stated that although preliminary results of the Burden of stroke would be jointly discussed by SAFE, ESO and the industry at the SAFE Working Conference in Amsterdam in December 2016, all the recommendations will be decided solely by ESO and SAFE before publication.

Meeting report as .pdf

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