Health Policy

Head

Alessandro

Nobili

Researcher

Dipartimento di Ricerca Politiche per la Salute

alessandro.nobili@marionegri.it

Staff

Gabriella

Miglio

Assistant

Dipartimento di Ricerca Politiche per la Salute

gabriella.miglio@marionegri.it

Senior Advisor

No items found.

The Department of Health Policy aims to develop research, training and information activities to:

support the independence, accessibility and universality of the Italian National Health Service;
promote health policies aimed at protecting people's right to health;
improve prevention and access to care;
provide support to institutional bodies in planning and evaluating health policies, with a particular focus on appropriateness and waste reduction.

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ObJECTIVES

to provide methodological support for the organisation, planning and evaluation of social and health policies and their associated costs within the Italian national health service;
to promote preventive measures and healthy lifestyles as an alternative to the use of pharmaceuticals and as a strategy for healthy ageing;
to study biological, dietary, environmental and social risk factors associated with population ageing and the onset of dementia;
to promote prescriptive appropriateness and the ethics of waste reduction in various national health service care settings;
to rationalise the use of drugs and promote deprescribing to minimise polypharmacy in elderly people and other at-risk populations;
to promote clinical research in community medicine and the integration of care within the personal services network;
to develop organisational strategies and support the implementation of psychosocial interventions to support community mental health services;
to implement independent training and information interventions to promote prescriptive appropriateness among national health service professionals;
to structure interventions and strategies from patients' point of view.

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METHODOLOGICAL APPROACHES

design and implementation of epidemiological studies in Italy, in hospitals, in residential care settings and in community mental health services;
clinical and epidemiological studies in general medicine and cardiovascular prevention;
design, coordination and analysis of registers for the study of geriatric populations;
analysis of large administrative databases in the field of real-world evidence and health planning;
participation in national and international networks to study factors related to ageing and cardiovascular risk;
projects aimed at studying and monitoring the appropriateness of drug use in elderly people on polypharmacy and other frail populations;
development and validation of tools for the assessment of drug interactions, iatrogenic risk, adherence to treatment and deprescribing;
methods and models for the economic evaluation (cost-benefit analysis) of health care interventions and services;
development and use of quality indicators for the evaluation of interventions in the health and social care sector;
models for benchmarking national and international social and health services;
verification of the effectiveness of healthcare interventions using controlled clinical studies, also using innovative tools.

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Results

Improvements in the prevention of cardiovascular disease through the implementation of personalised prevention strategies in general practice.
Improvements in secondary prevention of myocardial infarction through the use of the polypill.
The problem of therapeutic adherence affects patients of all ages, but the elderly are the population most at risk.
The presence of mild anaemia is a predictor of resuscitation in elderly patients, while the risk of mortality at three months increases in proportion to the severity of the anaemia.
There is a high degree of inappropriate prescribing in elderly hospitalised persons.
The computerisation of diagnostic-prescribing processes and the use of computerised tools provide new potential and opportunities for evaluating and monitoring prescriptive appropriateness and for the rationalisation of drug prescription.
INTERCheck-WEB® is a computerised support system for physicians and healthcare professionals to optimise drug prescribing, which is used in various practices and in different hospitals, long-term care, and primary care facilities.
Nutrition, together with other modifiable risk factors, plays a key role in reducing the risk of dementia not only in middle age, but also in the elderly, aged 80 or above.
Psychological interventions have recognised effectiveness in treating depression and other mental disorders.
People with bipolar disorder have only sporadic access to proven psychosocial treatments.

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Current projects

EPIFRAM-Anziani Project: Implementation of integrated and shared strategies to promote the management of prescriptive appropriateness and continuity of care for elderly patients with multimorbidity and polypharmacy

Sponsor: DG Welfare Regione Lombardia

Research area: Pharmaco-epidemiology

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REPOSI Register: REgistro dei pazienti per lo studio delle POlipatologie e politerapie in reparti della rete SIMI (REgister of patients for the study of POlypatologies and polypharmacies in SIMI network departments)

Sponsor: Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan

Research area: Prescriptive appropriateness

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LAPTOP-PPI Study: Study to promote the appropriate use of proton pump inhibitors in elderly populations

Sponsor: Ministero della Salute (Ricerca Finalazzata-Giovani) (Italian Ministry for Health)

Research area: Prescriptive appropriateness

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Collaborative project with AUSL Toscana Centro and Toscana Nord Ovest to activate interventions aimed at promoting appropriate prescribing and the containment of pharmaceutical spending

Sponsor: AUSL Toscana Centro and Toscana Nord Ovest

Research area: Prescriptive appropriateness

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Segesta Project: Evaluation of prescriptive appropriateness in RSAs (residential care facilities)

Sponsor: Segesta 200 srl

Research area: Prescriptive appropriateness

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INTERCheck: WebMedica, Angelini, Unihospital, Tiknil, CF AVEC, COOP Selios

Sponsor: Various

Research area: Prescriptive appropriateness‍

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PROMISING: aPpROccio alla MedIcina di preciSIoNe in Geriatria: dalle basi biomolecolari dell'invecchiamento e delle malattie età correlate ai modelli clinico-assistenziali (Approaching precision medicine in geriatrics: from the biomolecular basis of ageing and age-related diseases to clinical and care models)

Sponsor: Ministero della salute (Italian Ministry for Health)

Research area: Ageing

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TRICS Project: Multicenter Translational Trial of Remote Ischaemic Conditioning in Acute Ischaemic Stroke

Sponsor: Ministero dell’Università e della Ricerca (Italian Ministry of Education, Universities and Research)

Research area: Cerebrovascular diseases (stroke)

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SMUPH Project: Prospective multicenter study of physicians' and nurses' estimation of hospice patients’ length of stay

Sponsor: Hospice Via di Natale

Research area: End of life

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Pronto Badante Project (Ready Caregiver Project)

Sponsor: Associazione Esculapio Onlus

Research area: Services and Ageing

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APSS Provincia Autonoma di Trento Project: Non-pharmacological treatments for insomnia

Sponsor: ASS Provincia Autonoma di Trento

Research area: Sleep disorders

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Bolton Food Spa: Evaluation of the effect of canned fish consumption on the incidence of cancers of the gastrointestinal tract

Sponsor: Bolton Group

Research area: IIPH, nutrition

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Secure

Funding body: European Commission (Horizon 2020)

Research area: secondary heart attack prevention

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CV Prevital

Sponsor: Ministero Salute - Rete Cardiologica (Italian Ministry of Health - Cardiology Network)

Research area: Cardiovascular Disease Prevention - Digital health

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SKIM

Sponsor: Ministero Salute (Italian Ministry of Health)

Research area: Cardiovascular disease

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PAD & CAD

Sponsor: Bayer

Research area: peripheral arterial disease, coronary artery disease

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Clinical and imaging biomarkers associated with plasma and cellular determinants of CV diseases during the Covid-19 pandemic

Sponsor: Ministero Salute - Rete Cardiologica (Italian Ministry of Health - Cardiology Network)

Research area: Cardiovascular diseases and Covid-19

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Clinical symptoms of cardiovascular disease and their attribution to long Covid

Sponsor: Ministero Salute - Rete Cardiologica (Italian Ministry of Health - Cardiology Network)

Research area: Long Covid

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Long Covid Survey in General Medicine

Sponsor: none

Research area: Long Covid in General Medicine

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OTHER ACTIVITIES/WORK/PROJECTS:‍

First-level Master’s Degree in Clinical Research - Università degli Studi di Milano - Training/Education
Medication Information Service for the Elderly - Mario Negri Institute for Pharmacological Research - Information