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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

EPIFARM-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
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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.

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