18 May 2023

We CARE in 2023: Measuring the pandemic’s impact and developing tools to build resilience for the future

The COVID-19 pandemic caused huge disruption to healthcare services and dramatically reduced hospital admissions for MI.¹ In response, the We CARE initiative was created from a collaboration between PCR and Stent – Save a Life! to rebuild patient confidence in pursuing timely medical treatment and to help stakeholders provide effective and timely cardiac care through knowledge, education and training.

“Studies conducted by We CARE highlight the huge impact of delaying or stopping STEMI treatment during lockdowns,” explains William Wijns, a Core Team member of We CARE. “In an analysis of the socio-economic effects of disrupting STEMI treatment during the first lockdown in the UK, we found that for each patient, approximately 1.55 life years were lost and there was an estimated societal cost burden of €41.3 million.

Results were even more alarming from Spain: 2.03 life years were lost per affected individual and the societal cost burden was estimated to be €88.6 million. What’s more, these data – which will be published in full very soon² – do not include the long-term consequences. We are currently conducting similar analyses on the impact of delayed STEMI treatment in countries with different healthcare systems, including Sweden and France, and while we do not have the exact figures yet, we predict a heavy burden.”

We CARE is now using these analyses as a lever to advocate for better resilience in cardiac care systems. “A major issue for healthcare systems during the pandemic was that they were generally unprepared,” says Professor Wijns. “One of the main current aims of We CARE is to ensure that all stakeholders are ready for future challenging situations so that history does not repeat itself. During the pandemic we learned many lessons about what to do and what not to do to keep our cathlabs running.

We are hoping to get EU funding for the RESIL-Card project in which we build and validate a resilience assessment tool that cardiology departments and hospitals can take to see if they are prepared for the next catastrophe.” In the first development phase of the RESIL-Card project, Professor Wijns explains that a ‘bottom-up’ approach will be employed that gathers collective experience from the field and combines this with findings from the many published articles in the literature. Designed to be simple and practical, the tool will be developed with the help of a consortium of experts in healthcare delivery from the Netherlands, Catalunya and Italy, and by calling upon the expertise of the global PCR community, in particular the PCR Companions. “We will also enlist the support of patients, via patient organisations, to ensure their experience is captured in the design and delivery of the resilience tool,” notes Professor Wijns.

We CARE is also supporting countries that are interested in increasing local awareness about cardiac care challenges raised or exacerbated by the pandemic. For example, We CARE is working with Hakim Benamer and the French Group of Atheroma and Interventional Cardiology (GACI) on a project proposal to increase knowledge of the general public and public authorities on the importance of AMI and the need to seek care, particularly focussing on underdiagnosis in women. “We know that some patient groups were disproportionately affected by the disruption of STEMI treatment during the pandemic, including women and also those of lower socioeconomic groups and in rural communities. To make sure our work has the biggest impact, it’s important to identify groups who are at the greatest risk and who may suffer most from the consequences of undertreatment.”

Professor Wijns concludes that the work of We CARE may itself be creating a ‘virtuous cycle.’ He explains, “We hope that our work in optimising care and improving the resilience of STEMI management under difficult situations might have benefits for the management of other acute cardiovascular conditions, such as severe aortic stenosis, stroke and pulmonary embolism. In addition, as we try to work on the continuity of care that was lost during the pandemic, we want to encourage increased interactions between interventional cardiologists and all the other healthcare providers involved in STEMI care for a more coordinated approach in good times and in bad.”

References

Mafham MM, et al. Lancet. 2020;396:381–389.
Lunardi M, et al. Eur Heart J Qual Care Clin Outcomes. 2023; in press.