Stroke systems of care in the Philippines: Addressing gaps and developing strategies

Collantes, Maria Epifania V.; Navarro, Jose C.; Belen, Allan; Gan, Robert N.

doi:10.3389/fneur.2022.1046351

Cited by 8 publications

(12 citation statements)

References 16 publications

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“…Furthermore, we noted that the AAPC of age-standardized metrics showed an increasing trend in Philippines in Southeast Asia. A study found that stroke mortality in Philippines has remained high over the past decade, which is similar to our findings ( 29 ). In low- and middle-income countries, dietary patterns are changing considerably, such as the replacement of staple-based diets with increased fat, meat and salt intakes ( 30 ).…”

Section: Discussionsupporting

confidence: 92%

Burden and trends of stroke attributable to dietary risk factors from 1990 to 2019 in the Belt and Road Initiative countries: an analysis from the global burden of disease study 2019

Zhang

Luo

et al. 2023

Front. Nutr.

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ObjectivesThis study aimed to compare the burden and trends of stroke attributed to dietary risk factors in the Belt and Road (“B&R”) countries from 1990 to 2019.MethodsThe 2019 Global Burden of Disease (GBD) Study was used to gather information on the burden of stroke attributable to dietary risk factors. Numbers and age-standardized rates (ASRs) of deaths, disability-adjusted life years (DALYs) were determined in 1990 and 2019 among the “B&R” countries. The average annual percent change (AAPC) was used to analyze the temporal trends of diet-induced stroke DALYs from 1990 to 2019 and in the final decade (2010–2019) by Joinpoint regression analysis.ResultsIn 2019, the absolute number of stroke deaths and DALYs attributable to dietary risk factors were 671,872 cases (95% UI 436,354–937,093) and 1.67 million cases (95% UI 1.15–2.24) in China. We found geographical differences in mortality and DALYs of diet-attributable stroke among member countries, with Bulgaria, Hungary and Serbia being the three highest countries in 1990, Bulgaria, North Macedonia and Montenegro in Central Asia in 2019. The ASRs of diet-induced stroke mortality and DALYs were generally declining in most member states from 1990 to 2019, however, the corresponding metrics in Mongolia remained high. The fastest decline in ASR of mortality and DALYs for diet-induced stroke was seen in Estonia, Eastern Europe, with AAPC values of −7.09% (95%CI: −7.72, −6.46%) and − 6.62% (95%CI: −7.20, −6.03%), respectively. We noted a substantial downward trend in ASR of mortality and DALYs from diet-induced stroke changes in the final decade (2010–2019) for most member states. The ASR of DALYs for diet-induced stroke decreased greater in females than in males. For those aged 50–74, the DALYs for stroke due to dietary risk factors in all other member countries of the “B&R” showed a decreasing trend, except for the Philippines, which rose (AAPC = 2.13, 95%CI: 1.40–2.87%) and Turkmenistan, which remained stable (AAPC = 0.05, 95%CI: −0.43–0.33%).ConclusionThe burden of diet-induced stroke varies substantially across “B&R” countries and threaten public health, relevant evidence-based policies and interventions should be adopted to address the future burden of stroke in “B&R” countries through extensive collaboration.

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Section: Discussionsupporting

confidence: 92%

Burden and trends of stroke attributable to dietary risk factors from 1990 to 2019 in the Belt and Road Initiative countries: an analysis from the global burden of disease study 2019

Zhang

Luo

et al. 2023

Front. Nutr.

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“…Two reviews are included in this scoping review. One review on neurocritical care was published in 2022 and explores the current shortcomings in the management of stroke care and the subsequent courses of action to augment these gaps 49 . The second review was published in 1995 and gave an overview of the state of Philippine emergency medicine at the time 2 .…”

Section: Discussionmentioning

confidence: 99%

“…One review on neurocritical care was published in 2022 and explores the current shortcomings in the management of stroke care and the subsequent courses of action to augment these gaps. 49 The second review was published in 1995 and gave an overview of the state of Philippine emergency medicine at the time. 2 It provided information regarding the existing emergency medicine training programs, EDs, EMS systems, emergency physicians, and research.…”

Section: Discussionmentioning

confidence: 99%

Emergency medicine research in the Philippines: A scoping review

Vista,

Alibin,

Arevalo

et al. 2023

JACEP Open

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ObjectivesIn this review, we aim to synthesize the current emergency medicine literature in the Philippines in order to determine the depth of research available in the country while delineating the gaps, helping to provide focus to future research in the field.MethodsA literature review was done using 4 databases to identify emergency medicine studies in the Philippines. To explore the research trends among eligible studies, data on study type, countries, and institutions involved as well as study themes were collected and described.ResultsA total of 845 studies were screened, and 43 were included in this review. Results show that only 25% of emergency medicine studies were published before 2015. Most studies were observational (37.2%) or descriptive (37.2%) in nature with the University of the Philippines/Philippine General Hospital being the most common contributing institution (17.4%). Metro Manila was the most common study site with more than half of studies conducted in the area. Lastly, among the variety of study disciplines, disaster medicine was the most frequent topic comprising 30.2% of studies reviewed.ConclusionsCompared to the global scene, Philippine emergency medicine research still has a long way to go. This study was able to provide a landscape of the current literature and highlight the study trends. Further, the findings here emphasize the need to expand the scope of emergency medicine studies in the country as it is still a young and growing field with studies tending to cluster around just a small number of institutions and regions.

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“…Worldwide, stroke is a leading cause of mortality and disability 1. The prevalence of stroke in the Philippines ranges from 0.5% to 1.9%, with age-standardized mortality of 82.8 per 100,000 person-years 2–6. In 2017, it ranks as the second most common cause of death after heart disease in the country.…”

mentioning

confidence: 99%

“…1 The prevalence of stroke in the Philippines ranges from 0.5% to 1.9%, with age-standardized mortality of 82.8 per 100,000 person-years. [2][3][4][5][6] In 2017, it ranks as the second most common cause of death after heart disease in the country. The stroke burden in terms of age-standardized and sex-standardized disability-adjusted life years lost is 2171/100,000 people.…”

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confidence: 99%

A Call for a Stroke Referral Network Between Primary Care and Stroke-Ready Hospitals in the Philippines

Espiritu

María

2021

The Neurologist

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Background: The increasing stroke burden, inequity in the distribution of local neurologists, and the recent signing of the Universal Health Care Law in the Philippines provide compelling reasons for policy-makers to devise strategies to establish networks between primary care and stroke-ready hospitals. In this review, we explored the current literature and evidence that emphasized the roles of primary care providers (PCPs) and specialists, care transition, and telemedicine/teleneurology in various stages of stroke management. Review Summary: Clear delegation of stroke care responsibilities among PCPs and specialists is needed. Due to the limited number of specialists/neurologists, PCPs may contribute to addressing the insufficiency of community knowledge of acute stroke symptoms/risk factors, coordination with specialists and stroke-ready hospitals during acute stroke, and continuity of care during the poststroke stage. At present, the Philippines has only 49 stroke-ready hospitals; thus, an efficient and functional referral system for the care transition between the PCPs and specialists must be organized in our country. To provide remote access to expert stroke care for underserved areas and to increase thrombolysis utilization, the establishment of an effective telestroke system is indispensable. The empowerment of PCPs in teleneurology may assist in strengthening communication and networking with specialists with the ultimate goal of improving patient outcomes. Conclusions: In the era of Universal Health Care in the Philippines, the roles of PCP and specialists must be delineated. Increased access to stroke care through the establishment of networks among PCPs and stroke-ready hospitals (ie, via effective transition of care/teleneurology) must be prioritized especially in resource-constrained settings.

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Stroke systems of care in the Philippines: Addressing gaps and developing strategies

Cited by 8 publications

References 16 publications

Burden and trends of stroke attributable to dietary risk factors from 1990 to 2019 in the Belt and Road Initiative countries: an analysis from the global burden of disease study 2019

Burden and trends of stroke attributable to dietary risk factors from 1990 to 2019 in the Belt and Road Initiative countries: an analysis from the global burden of disease study 2019

Emergency medicine research in the Philippines: A scoping review

A Call for a Stroke Referral Network Between Primary Care and Stroke-Ready Hospitals in the Philippines

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