The priorities for future stroke research

Stroke is a leading cause of adult disability and the fourth biggest killer in the UK (1). Whilst stroke mortality (age-standardised) has almost halved, the incidence and prevalence of stroke is rising. There are 1.3 million stroke survivors in the UK (2), and this figure is set to increase to over 2 million, by 2035 (3). The reduced mortality rate for stroke is worth celebrating – there are hundreds of thousands of people in the UK who wouldn’t be here today if it weren’t for the leaps and bounds in our understanding of acute treatment for stroke.

The Stroke Association is an example of an organisation that has played a crucial role in supporting stroke research in the UK and has been involved with major breakthroughs in treatment and care. This includes thrombolysis and thrombectomy which radically improve outcomes for ischaemic stroke.

However, the improvements that we have seen in acute stroke treatment have not been replicated in rehabilitation and community care. With more stroke survivors surviving and living with the long-term effects of stroke – almost two-thirds of stroke survivors leave hospital with a disability (2), two-thirds of stroke survivors have problems with their speech and communication and four in ten experience depression and/or anxiety (4), we need to ensure that equivalent advances are seen across the stroke pathway.

Despite the huge impact of stroke, the picture we see now for research is bleak, just 1.2% of UK public and charity health research spend is on stroke (5). Given the urgent need for innovation in stroke care and the lack of funds for stroke research, our charity is calling for an increase in stroke research funding and for these limited funds to be invested in the areas that will most change stroke survivors’ lives. We need to be in a position where we can support the growing numbers of stroke survivors, who are living with the life-changing effects of stroke.

Our charity, the Stroke Association has announced the areas future research must focus on to improve stroke care. The announcement of these research priorities, which have been set by stroke survivors, carers and professionals, marks the first UK-wide project spanning the entire stroke care pathway. The findings are being shared in the charity’s new report “Shaping stroke research to rebuild lives: The Stroke Priority Setting Partnership results for investment.”

The priorities were established in the Stroke Priority Setting Partnership (Stroke PSP) using the well-established James Lind Alliance process to ensure credible, patient-centric outputs (6). The findings provide a road map to direct the activities of funding bodies, researchers and decision-makers investing in stroke research.

The Stroke PSP produced two priority lists of 10 uncertainties, ranked in order of importance – the first on prevention, pre-hospital and hospital care, the second in rehabilitation and long-term care. These lists reflect the diverse and complex field of stroke and the opportunities for innovation in research. The number one priorities are primary prevention of stroke, and diagnosis, prevention and treatment of the psychological impacts of stroke.