Abstract Background and aims Risk and impact of stroke recurrence is high. Advancements in secondary stroke prevention (SSP) have not substantially reduced since the millennium. Consensus (75% agreement) was gained by a multi-stakeholder expert panel on challenges in SSP. We present their call for multistakeholder action to enable meaningful reduction in recurrence risk and improved patient outcomes. Methods We conducted a modified Delphi study with 13 international stroke experts, including stroke survivors and patient advocates. After two anonymous survey rounds and one discussion, consensus was achieved on 11 statements relating to challenges in SSP treatment and management. Results Our study achieved consensus that sustained investment in management, support and new treatment options for SSP is needed to improve quality of life for survivors and caregivers, and to achieve long-term cost savings. Optimal prevention of recurrence requires healthcare professionals, stroke survivors and their caregivers to be ‘partners in prevention’. Consensus on this was achieved by 100% of panel members following the discussion round. Our analysis also identified measures for implementation and advocacy to improve outcomes for stroke survivors. Conclusions We demonstrate multidisciplinary consensus on the need for sustained attention to SSP management, support and innovation. This will enable new developments in SSP to achieve their potential to improve outcomes, while optimising use of post-stroke resources. Realisation of these changes will require aligned action across key stakeholders, including those involved in stroke care and beyond – with stroke and cardiovascular health plans including SSP, supported by clear guidelines and policies. Conflict of interest All authors received honoraria from Bayer AG in recognition of their participation in the Delphi process. VC reports receiving payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing or educational events from Daiichi Sankyo, Pfizer BMS, Bayer and Ever Pharma; consulting fees from Daiichi Sankyo, Pfizer BMS and Bayer; support for attending meetings and/or travel for Daiichi Sankyo, Bayer and Ever Pharma; participation on a data safety monitoring board or advisory board for Bayer. TH reports payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing or educational events from Bayer and Daiichi Sankyo. LL reports she is the Deputy vice president of Chinese stroke association (unpaid role). GMD reports consulting fees from Bayer as well as being part of a steering committee. CC reports payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing or educational events from Biogen, BMS, Bayer, Amgen; participation on a data safety monitoring board or advisory board from Novartis and Boehringer-Ingelheim. The other authors report no competing interests.
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Valeria Caso
Julio Agredano
Charlotte Cordonnier
European Stroke Journal
Université de Lille
Capital Medical University
Hospital Universitario Ramón y Cajal
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Caso et al. (Fri,) studied this question.
www.synapsesocial.com/papers/69fd7e5cbfa21ec5bbf06830 — DOI: https://doi.org/10.1093/esj/aakag023.1331