New research on predicted increase in stroke cases here prompts Irish Heart Foundation to demand urgent investment

The Irish Heart Foundation has said that Ireland is facing a “tsunami” of stroke cases by 2030 following new research which has warned that the rate of stroke here will soar to almost 12,000 new strokes a year in 10 years’ time – an increase of 58 per cent.

The new study ‘At What Cost- the Economic Impact of Stroke in Europe’ which was commissioned by the Stroke Alliance for Europe (SAFE) of which the Irish Heart Foundation is a member, was carried out by the heath economics team at the University of Oxford in the UK, pre COVID-19.

According to the report, this increase in new strokes in Ireland, predicted to be among the highest in Europe, will see the cost of stroke here increase by almost 40 per cent.

Approximately 7,500 people in Ireland are currently hospitalised due to stroke each year, according to the HSE’s National Stroke Programme.

The SAFE report also revealed that Ireland spends less than 1 per cent of its total health budget on stroke, around half the European average and a quarter of the amount spent by other countries.

“These findings demonstrate yet again how low stroke is on our list of health priorities, despite being Ireland’s third largest killer disease and the biggest cause of acquired disability,” said Chris Macey, Head of Advocacy at the Irish Heart Foundation.

“This research, conducted by the University of Oxford for SAFE, shows the tsunami of new strokes we are facing in Ireland is due mainly to our ageing population.

“It is a wake-up call to health service planners that a failure to invest now to futureproof already chronically underfunded services will not just overwhelm our stroke units, but will also create a major and inevitable spill over that will impinge on other services at acute hospitals.

“Tackling this decisively now will not just save lives and promote recovery on a large scale among stroke sufferers, it will significantly reduce the overall cost of the disease for a health service that is on its knees due to the pandemic.”

Among the 32 nations surveyed for the report, Ireland was one of the most reliant on informal care or that provided by family and friends. An estimated 4.5 million hours of informal care is currently provided here every year, translating to an average of 1,300 hours per stroke survivor.

Mr Macey argued that Ireland’s soon-to-be-published first ever national stroke strategy must come with funding to provide adequate levels of medical, nursing and therapy expertise, along with the resourcing of lifesaving treatments.

“The vast majority of stroke units do not have the staffing and physical resources to meet minimum international standards and therefore to maximise their lifesaving potential,” he said.

“More must also be done to promote recovery. Research from the ESRI shows that the State spends up to 60 times more on nursing home accommodation for stroke survivors than on community rehabilitation programmes that could enable many to continue living at home.

“The University of Oxford research estimates that community rehabilitation has a bigger impact on patient recovery at less expense than in hospital rehabilitation services.

“By investing in treatment, rehabilitation and community-based recovery services, we can reduce the need for nursing home care and thereby, overall stroke costs.

“It is crucial that the new strategy ensures that every stroke patient returning home is entitled to a needs assessment, a discharge plan, a referral to a community rehabilitation service and access to ongoing social support in their community.

“Currently the system is effectively penny pinching until after it can help patients make the best possible recovery and then spending huge amounts on their institutional care.

“We don’t need more money to help stroke survivors maximise their quality of life. We just need to spend it more effectively.”

The SAFE study included all stroke-related costs that occurred in EU countries plus the UK, Israel, Norway, Iceland and Switzerland in 2017.

In addition, the report looks at three interventions which are in the latest stroke guidelines – the treatment of atrial fibrillation to prevent stroke, mechanical thrombectomy (the clot retrieval from the blood vessel in the brain) in the acute phase of stroke and community-based rehabilitation after stroke. The research revealed that no matter at which point in the stroke pathway you intervene – prevention, treatment, long-term care – there’s likely big gains to be had in terms of patient outcomes and cost savings.

According to the report, in 2017, nearly 1.5 million people suffered a stroke, nine million Europeans lived with a stroke, and more than 430,000 people died due to a stroke in the 32 countries under this study. The total cost of stroke in 2017 was a €60 billion.

The number of new strokes and the number of people living with stroke is set to rise due to ageing population in Europe, as age is the biggest, non-modifiable risk factor for stroke. The costs of stroke are projected to increase by 44 per cent between 2017 and 2040, with some countries seeing rises in stroke-related costs of nearly 100 per cent, the report found.