Calizzani Gabriele, Menichini Ivana, Candura Fabio, Lanzoni Monica, Profili Samantha, Tamburrini Maria Rita, Fortino Antonio, Vaglio Stefania, Marano Giuseppe, Facco Giuseppina, Oliovecchio Emily, Franchini Massimo, Coppola Antonio, Arcieri Romano, Bon Cinzia, Saia Mario, Nuti Sabina, Morfini Massimo, Liumbruno Giancarlo M, Di Minno Giovanni, Grazzini Giuliano
National Blood Centre, National Institute of Health, Rome, Italy.
Italian Federation of Haemophilia Societies (FedEmo), Rome, Italy Necstep Studio Associato, Modena, Italy.
Blood Transfus. 2014 Apr;12 Suppl 3(Suppl 3):s582-8. doi: 10.2450/2014.0087-14s.
Due to the increase in life expectancy, patients with haemophilia and other inherited bleeding disorders are experiencing age-related comorbidities that present new challenges. In order to meet current and emerging needs, a model for healthcare pathways was developed through a project funded by the Italian Ministry of Health. The project aimed to prevent or reduce the social-health burden of the disease and its complications.
The National Blood Centre appointed a panel of experts comprising clinicians, patients, National and Regional Health Authority representatives. Following an analysis of the scientific and regulatory references, the panel drafted a technical proposal containing recommendations for Regional Health Authorities, which has been formally submitted to the Ministry of Health. Finally, a set of indicators to monitor haemophilia care provision has been defined.
In the technical document, the panel of experts proposed the adoption of health policy recommendations summarised in areas, such as: multidisciplinary integrated approach for optimal healthcare provision; networking and protocols for emergency care; home therapy; registries/databases; replacement therapy supply and distribution; recruitment and training of experts in bleeding disorders. The recommendations became the content of proposal of agreement between the Government and the Regions. Monitoring and evaluation of haemophilia care through the set of established indicators was partially performed due to limited available data.
The project provided recommendations for the clinical and organisational management of patient with haemophilia. A particular concern was given to those areas that play a critical role in the comorbidities and complications prevention. Recommendations are expected to harmonise healthcare care delivery across regional networks and building the foundation for the national haemophilia network.
由于预期寿命的增加,血友病和其他遗传性出血性疾病患者正面临与年龄相关的合并症,这带来了新的挑战。为了满足当前和新出现的需求,通过意大利卫生部资助的一个项目开发了一种医疗保健途径模式。该项目旨在预防或减轻该疾病及其并发症的社会健康负担。
国家血液中心任命了一个由临床医生、患者、国家和地区卫生当局代表组成的专家小组。在分析科学和监管参考文献后,该小组起草了一份技术提案,其中包含给地区卫生当局的建议,并已正式提交给卫生部。最后,确定了一套监测血友病护理提供情况的指标。
在这份技术文件中,专家小组提出了在以下领域总结的卫生政策建议:提供最佳医疗保健的多学科综合方法;急诊护理的网络和协议;家庭治疗;登记处/数据库;替代疗法的供应和分配;出血性疾病专家的招募和培训。这些建议成为了政府与各地区之间协议提案的内容。由于可用数据有限,通过既定指标对血友病护理的监测和评估仅部分进行。
该项目为血友病患者的临床和组织管理提供了建议。特别关注那些在合并症和并发症预防中起关键作用的领域。这些建议有望协调各地区网络的医疗服务提供,并为国家血友病网络奠定基础。