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Decision SupporT and self-mAnagement system for stRoke survivoRs

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Innovative system empowers stroke survivors to lead healthier lives

The risk of suffering a second stroke increases mainly due to patients’ lack of commitment to treatment. An EU initiative has addressed this issue by providing survivors with information, motivational drivers and continuous professional support to help them better manage their condition, live independently and ultimately prevent a secondary stroke.

Digital Economy

When it comes to death and disability, recurrent or secondary stroke carries a greater risk than first-ever stroke. While mortality rates from first-ever strokes have gone down the past few years, the opposite is true for secondary strokes. “Secondary stroke prevention has proven successful in the lab, but much less so amongst the general population,” says Margarita Anastassova, coordinator of the EU-funded STARR project. One of the main reasons is that quality healthcare outcomes depend on patients’ adherence to recommended treatments. “However, this adherence remains a challenge.”

User-centred design approach to stroke prevention

After consulting more than 160 stroke survivors, carers and medical professionals in Spain, France, Sweden and the United Kingdom, the STARR team developed a modular, cost-efficient and user-friendly decision support and self-management system. It informs stroke survivors about the link between their daily activities like medication intake, physical activity and diet and their risk of having a secondary stroke. The system is based on an existing computational predictive model that calculates the risk of having a secondary stroke. It’s also based on innovative wearables for physical activity sensing, connected medical devices for controlling medical parameters like blood pressure and cholesterol levels, as well as self-management services for stroke survivors that make recommendations and give support for improving the adherence to prescribed treatments and adopting a healthier lifestyle. Mobile apps, serious games and a vision-based sensing platform for exercising at home are the main self-management services integrated into the system. Stroke survivors will be able to live a healthier life, practice rehabilitation alone or with a therapist, and better control hypertension to avoid a secondary stroke.

Clear benefits for recovering patients

Project partners evaluated the system’s usefulness, usability and accessibility, as well as its effect on stroke survivors’ and carers’ quality of life and autonomy. They installed the innovation in the homes of 18 Spanish stroke survivors who were asked to use it on their own over a 6-month pilot phase. The majority (83 %) were very satisfied and showed improved independence and knowledge of stroke risk factors. Blood pressure control also got better. There was only one emergency admission that proved timely in coping with a severe increase in blood pressure that could have led to a stroke. Finally, they had more timely and informed consultations with specialists and general practitioners than the group that didn’t use the system during the same amount of time. This group suffered one fatality and two transient ischaemic attacks. STARR’s technological solutions will positively impact stroke survivors’ independence by providing them with suitable information and motivational elements to better control key health parameters like hypertension and diet. “Such improved control should lead to less hospital and emergency readmissions, and more timely and informed consultations with general practitioners and specialists,” explains Anastassova. There’s genuine interest in the system and its integrated services from both stroke survivors and health professionals. Some of the project partners plan to commercially exploit or further develop the standalone services. “We expect the STARR system to be an invaluable companion for stroke survivors and their carers when it goes to market,” concludes Anastassova.


STARR, stroke, stroke survivor, secondary stroke, patient, health, rehabilitation

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