Stroke
About this PSP
There were over 1.2 million stroke survivors in the UK in June 2019, when the Stroke Priority Setting Partnership (Stroke PSP) started. Thanks to huge advances in emergency care and treatment, there are more people surviving stroke than ever. But stroke has devastating effects and stroke survivors, as well as those close to them, have complex needs for long-term support.
Research can find new ways and improve how we stop, spot, treat and support those affected by stroke. But a the time of publishing the Stroke PSP research priorities, only £25 was dedicated to research per stroke survivor in a year. This compared to £161 per person living with cancer.
The Stroke Association led this PSP driven by its core purpose to be the trusted voice of those affected by stroke and to improve outcomes in stroke prevention, treatment and lifelong support. The project was made possible with the partnership and support of many individuals and organisations in the stroke community.
In order to address the priority areas established in the Stroke PSP, and improve the lives of people affected by stroke, investment in stroke research must significantly increase.
There are two lists of Top 10 priorities: the first in stroke prevention, diagnosis, pre-hospital and hospital care, and the second in stroke rehabilitation and long-term care. Both were published in June 2021.
See news from this PSP: January 2021
Watch these short videos to learn more.
What is the Stroke PSP?
After the two Top 10s had been agreed, the Stroke Association, in partnership with KTN, held the ‘Action on stroke research priorities’ event. The event invited industry, academia, clinicians, funding and supporting organisations with expertise in stroke research, innovation and care to share their knowledge and develop new collaborations and partnerships to address evidence uncertainties established in the PSP. You can see the report from this event in the Key Documents section of this page.
Image at the top of this page is ©Stroke Association 2018
Key documents
Stroke PSP Steering Group Terms of Reference
Stroke Prevention, Diagnosis, Pre-hospital and Hospital Care Top 10 Priorities
- What are the best interventions to stop stroke happening for the first time (i.e. primary prevention)?
- How can the public, paramedics and other health care professionals recognise and respond to stroke or TIA better and more quickly?
- What are the benefits and risks of acute treatments for intracerebral haemorrhage (e.g. surgery and medications)?
- What are the benefits and risks of new therapies for stroke (e.g. stem cell therapy) and those that work to protect the brain from damage (i.e. neuroprotection)?
- What is the risk of recurrent stroke, how does this risk change over time, and what can stroke survivors do to reduce the likelihood of having another stroke (i.e. secondary prevention)?
- How can the proportion of patients with ischaemic stroke who get clot retrieval (thrombectomy) be increased either by using new ways to identify more patients that are eligible, or by increasing the number of specialist healthcare professionals who can carry out thrombectomy?
- What are the processes that cause delayed changes in brain function (neurological deficit) after subarachnoid haemorrhage caused by an aneurysm?
- How can complications of stroke be reduced (e.g. pneumonia)?
- What are the risks and benefits of using blood-thinning treatments (antiplatelet and anticoagulants) to stop stroke happening after TIA or haemorrhagic or ischaemic stroke? Is personalised decision-making possible for the timing and types of antiplatelet and anticoagulant therapy used?
- Do patients’ other health conditions, and characteristics such as age, ethnicity and frailty, affect stroke symptoms, outcomes, interventions and care pathways?
The following questions were also discussed and put in order of priority at the workshop:
- How do regional and other differences in access to stroke care affect outcomes for stroke survivors and their families?
- What effect does diet have on short and long-term outcomes for stroke survivors?
- What is the best timing and amount of early mobilisation for stroke survivors?
- What is the best body positioning for patients with stroke in the first hours after stroke?
Document downloads
For full details of all of the questions identified by this PSP, please see the document below.
Stroke Rehabilitation and Long-term Care Top 10 Priorities
- How common are psychological problems and what impact do they have on the lives of people affected by stroke (including the children of stroke survivors); what factors and interventions can best prevent psychological difficulties, support adjustment, and improve motivation, well-being and engagement; how cost-effective are these interventions and how can they be made available to people affected by stroke?
- What is the best way to assess for, understand the impacts of and track progression in all areas of cognition – including using standardised measures - across the stroke pathway; what and how can interventions and services involving multidisciplinary teams and families be made accessible, and how can information on these problems be provided?
- What are the effects of, and best assessments and interventions for, the range of communication difficulties in stroke survivors?
- How common is fatigue; what and why are there various types, causes/triggers and experiences of its effects? What are the best ways to recognise, reduce, treat and self-manage fatigue - including in young stroke survivors and for all types of stroke, including sub-arachnoid haemorrhage - to minimise the impact on recovery and life after stroke?
- How can community stroke services best be resourced and organised in all regions to provide effective home/community-based rehabilitation that meets the needs of all groups of stroke survivors such as ethnic groups, young people, stroke severities and those with multiple health conditions?
- What and how common are the long-term impacts of stroke on abilities necessary for every-day life; what, and how can, interventions be made available to facilitate these abilities?
- What is the best time, place and amount of therapy (e.g. speech and language therapy, physiotherapy, occupational therapy) to get the best outcomes for stroke survivors, and is this different than advised in the Stroke Guidelines (5 times a week for 45 minutes)?
- How can people supporting stroke survivors work best with the stroke care team, and what personalised training and support is available for carers to enable them to support stroke survivors and their recovery, including those with communication, cognitive and engagement difficulties?
- What are the best interventions including exercise to improve strength and fitness, promote recovery and prevent further stroke in stroke survivors?
- What do stroke survivors think and feel works well, or needs improvement as they move through the stroke pathway, including the intensity of rehabilitation; what can be done to improve the stroke survivor and carer experiences?
The following questions were also discussed and put in order of priority at the workshop:
- What is the best intervention to improve outcomes for people with severe stroke and long-term disability, and what can be gained from longer-term rehabilitation provided at home and in nursing homes?
- What are the factors that best predict, and make a difference to the speed, amount and timing of recovery, and how can healthcare professionals help early in the rehabilitation process to guide expectations for stroke survivors and families?
- What are the causes of different types of pain in stroke survivors, and what interventions are most effective in the prevention, treatment and management of pain?
- Is there a fixed time period after which stroke survivors make no measurable improvement with an intervention; if improvements can continue, what type and intensity of treatment is effective at a later stage?
- What interventions improve arm function after stroke and when should they be provided?
- What is the best way to increase the availability of on-going physiotherapy for stroke survivors?
- What are the public thoughts and feelings (perceptions) on these disabilities; what are the best ways to help people to understand these and improve attitudes toward, and support, stroke survivors?
- How can training for healthcare professionals be made the same to ensure the best outcomes for all stroke survivors and their carers?
Document downloads
For full details of all of the questions identified by this PSP, please see the document below.
Stroke Top 10s
The Stroke PSP set Top 10 priorities in two areas
Stroke prevention, diagnosis, pre-hospital and hospital care