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Managing the risk of having a second stroke

Europe is developing a decision support and self-management system to inform stroke survivors of the relation between their daily activities and the risk of having a second stroke. The objective is to improve prevention and reduce the number of people who have a second stroke.

Published on 15 April 2019

Worldwide, 16% of the population will have a stroke at some time in their lives; one person has a stroke every two seconds, and one person dies of stroke every four seconds. In Europe, in spite of the preventive measures implemented by national health systems, the number of stroke victims is set to increase from 1.1 million cases a year in 2000 to over 1.5 million in 2025.

At the same time, between 10% and 13% of cases are secondary strokes, which also have much worse consequences: there is a greater risk of death or more serious disability as a result of a second stroke than for a first stroke.

The risk factors are well known, 90% of stroke or secondary stroke cases could be averted by encouraging people to adopt healthier lifestyles. Among the potential solutions to this problem, self-management tools based on digital technology are especially interesting.

Working together under H2020, the partners involved in the STARR project hope to promote the self-management of stroke risk factors. Based on predictive computer models of stroke risk, they want to develop an affordable system that will be easy to install and to use. This system will be used to keep stroke survivors informed of how their daily activities relate to the risk of having a second stroke: medication intake, physical and cognitive exercises, diet, and social contacts will be proposed using a smartphone app to reduce their risk of secondary stroke. The aim is to improve prevention and reduce the incidence of secondary stroke, as well as to better involve patients in medical decision-taking.

A series of tests are in progress, in the homes of a number of patients in Spain and at a neurological rehabilitation center in France. To make this system available to patients as soon as possible, we already have three firms directly involved in the consortium. They will be able to use the project outcomes to roll out a solution as soon as possible », explained Margarita Anastassova (CEA-List), the project coordinator.

Over 1 million strokes a year in Europe

Cerebrovascular accident, or stroke, is a major cause of death and disability, estimated to cost 65 billion euros every year in Europe. Given that the mortality rate for primary stroke has decreased in recent years, the number of people at risk of secondary stroke has increased. As a result, the cost of care has also risen.

A recent study carried out by the Stroke Alliance For Europeshowed that healthcare costs vary depending on how serious the stroke is. The costs of slight to moderate cases are lower thanks to shorter hospital stays, while more serious cases imply higher costs due to the higher cost of intensive care, rehabilitation and subsequent residential home care. Furthermore, since the consequences of a stroke may last for the rest of a person's life, the total cost can be even higher. In Europe, the total cost of stroke was an estimated 64.1 billion euros in 2010. In 2010, the cost of a stroke was an estimated 21,000 euros per person. 

Members of the European Union's STARR Project ©Starr

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