A more systematic, evidence-based approach to public education across the EU is required to improve knowledge of the modifiable risk factors for stroke, i.e. an awareness that these factors significantly increase a person’s risk of stroke, but in most cases can be treated. Joining forces with public education efforts in relation to the other cardiovascular diseases could create a more powerful message and greater impact.
Current educational campaigns should be assessed for their effectiveness. Our understanding needs to go beyond measuring public knowledge and awareness to look at the extent to which they positively influence public behaviour over time. We should build on what works and make sure public education is both effective and cost effective. Innovative campaigning methods (such as: the use of social media, apps; collaborative campaigns in co-operation with other medical specialties; risk factor education in schools; and risk-factor checks in places such as workplaces or pharmacies) should be assessed.
Across Europe we need rapid and concerted action to prevent stroke and, especially, improvement in the detection and treatment of high blood pressure (hypertension) and atrial fibrillation (an abnormal heart rhythm with rapid and irregular beating). Medical professionals and patients must both be involved through shared decision-making, in order to increase adherence to existing guidelines, compliance with prescribed medications, and regular blood pressure checks.
Improvement in the diagnosis and management of AF is needed including systematic approaches to identifying and monitoring AF. The effectiveness and cost-effectiveness of AF screening policies of at-risk populations should be assessed in the respective health contexts of each country, as do new developments such as devices and apps for detecting AF, self-monitoring of INR, and new anti-coagulation therapies. A more systematic approach to monitoring guideline adherence (e.g. national or large regional audits), and possibly incentivising this adherence might improve treatment rates.
Timely assessment of suspected TIA patients in specialist clinics should be widely available.