Stroke Action Plan for Europe 2018-2030 (SAP-E): mid-term review and update

Christensen, Hanne and Pezzella, Francesca Romana and Roaldsen, Melinda Berg and Tomek, Ales and Wilkie, Arlene and Christensen, Louisa and Dichgans, Martin and Drummond, Avril and Laatikainen, Tiina and Molina, Carlos A. and Sunnerhagen, Katharina S. and Toni, Danilo and Abilleira, Sonia and Aguiar, De Sousa Diana and Arsovska, Anita and Audebert, Heinrich and Bartolovic, Jelena and Bejot, Yannick and Biessels, Geert Jan and Bouverie, Juliet and Budincevic, Hrvoje and Casolla, Barbara and Chabriat, Hugues and Charalambous, Marina and Dawson, Jesse and Debette, Stephanie and De, Leeuw Frank-Erik and Dénes, Ádám and Diomedi, Marina and Dippel, Diederik (2026) Stroke Action Plan for Europe 2018-2030 (SAP-E): mid-term review and update. EUROPEAN STROKE JOURNAL, 11 (1). No. -aakaf026. ISSN 2396-9873

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Abstract

Objectives Implementation of the Stroke Action Plan for Europe (2018-2030) (SAP-E) was initiated in 2019. It is now updated at mid-term to reflect and respond to challenges for stroke care in Europe in 2025.Methods The SAP-E covers the entire chain of stroke care. The sections (state of the art, current status and targets) were developed by working groups and finalised based on inputs from the Interim Review Committee and an open online meeting. Targets for 2030 were updated to reflect current knowledge, to prioritise and to increase accountability.Results All sections have been updated based on the newest evidence to reflect the state of the art and current status in 2025.Conclusion Stroke remains a significant health issue in Europe, with notable incidence and inequities in access to care. Key interventions are strongly evidence-based, cost-effective and supported by World Health Organization and European Union recommendations. Despite improvements, gaps remain across the care pathway but particularly in terms of access to stroke units, rehabilitation and follow-up. To control and reduce the burden of stroke, the main action points are: (1) national stroke plans, which encompass the entire chain of care and are reflected in reimbursement systems, (2) quality and outcome control, where impact is measured at both individual and health care system level, (3) robust and resilient health care organisation covering the entire chain of care that promotes equal access to sustainable, timely and evidence-based stroke care and (4) effective national strategies to promote and facilitate a healthy lifestyle and risk factor control.

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