3 Improving public awareness and understanding
of stroke
17. The Department recognised the importance of raising
public awareness and understanding of stroke, not only to increase
the likelihood that people would call for an ambulance if they
were having a stroke, but also to help develop services.[36]
In February 2009, the Department launched the Stroke—Act
F.A.S.T. campaign, which has been very effective in improving
the public's recognition of the symptoms of stroke and, as a result,
the number of stroke-related ambulance calls.[37]
The Department's campaign was easy to understand, making it more
likely that members of the public would get someone they thought
might be having a stroke to hospital quickly. The campaign had
also changed the profile and understanding of stroke for health
care professionals and GPs' receptionists, and the way that Accident
and Emergency Departments work.[38]
18. An important aspect of improving understanding
of stroke was to prevent strokes from occurring in the first place,
by increasing public awareness of the risk factors. These include
high blood pressure and cholesterol, smoking, unhealthy diet and
lack of exercise.[39]
The Department acknowledged that prevention was the biggest issue
for patients and their carers and that progress had been slow.[40]
One in five stroke patients were not aware, for example, that
lack of exercise increased their risk of a further stroke.[41]
The Department told us that in order to prevent a further stroke,
it was important to prescribe Aspirin to reduce the risk of blood
clotting. Prevention was especially important with increased emphasis
on managing high blood pressure, reducing obesity, giving up smoking,
and reducing cholesterol levels.[42]
19. Atrial fibrillation (irregular heart rhythm)
was another major risk factor for stroke. NHS Improvement estimated
that appropriate treatment of all people with atrial fibrillation
would prevent around 4,500 strokes each year, and would do so
cost-effectively.[43]
However, doctors were reticent about putting patients on the recommended
drug (warfarin) even when there were no contraindications, as
it involved regular monitoring. Some elderly patients had not
been prescribed warfarin due to doctors' perception that it increased
the impact of falling. However, recent evidence suggested that
even elderly people at high risk of falls were safer receiving
warfarin than being left untreated.[44]
20. Using a simple pulse test on those considered
to be at high risk had the potential to improve the diagnosis
and treatment of atrial fibrillation within primary care. The
Arrhythmia Alliance had raised awareness through its Know your
Pulse campaign and the Department's Stroke Improvement Programme
had developed a free-to-use tool to help identify patients who
could be treated with warfarin.[45]
36 Q 68 Back
37
Qq 15, 23 and 30; C&AG's Report, para 2.3, Figure 8 Back
38
Qq 15, 18 and 71 Back
39
C&AG's Report, para 3.17 Back
40
Q 54 Back
41
C&AG's Report, para 17 Back
42
Qq 54 and 55; C&AG's Report, paras 3.17 and 3.18 Back
43
C&AG's Report, para 18 Back
44
Q 21 Back
45
Qq 21 and 86 Back
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