Fibrates in the primary prevention of cardiovascular disease

Fibrats; Prevenció primària; Malaltia cardiovascular; Fàrmacs hipolipemiantsFibratos; Prevención primaria; Enfermedad cardiovascular; Fármacos hipolipemiantesFibrates; Primary prevention; Cardiovascular disease; Lipid-lowering drugsRecomanació Essencial sobre “Fibrats en la prevenció primària de la malaltia cardiovascular”, per la qual, no es recomana la prescripció rutinària de fibrats per a la prevenció primària de la malaltia cardiovascular. Essencial és un projecte de l'Agència de Qualitat i Avaluació Sanitàries de Catalunya del Departament de Salut per reduir o evitar les pràctiques clíniques de poc valor.Recomendación Essencial sobre "Fibrats en la prevenció primària de la malaltia cardiovascular”, por la cual no se recomienda la prescripción rutinaria de fibratos para la prevención primaria de la enfermedad cardiovascular. Essencial es un proyecto de la Agencia de Calidad y Evaluación Sanitarias de Cataluña del Departamento de Salud para reducir o evitar las prácticas clínicas de bajo valor.Essential Recommendation on “Fibrats en la prevenció primària de la malaltia cardiovascular,” which advises against the routine prescription of fibrates for the primary prevention of cardiovascular disease. Essencial is a project by the Catalan Agency for Health Quality and Assessment (AQuAS) under the Department of Health, aimed at reducing or avoiding low-value clinical practices

¿Es necesario que tome fibratos para prevenir enfermedades del corazón?

Fibrats; Prevenció primària; Malaltia cardiovascular; Fàrmacs hipolipemiantsFibratos; Prevención primaria; Enfermedad cardiovascular; Fármacos hipolipemiantesFibrates; Primary prevention; Cardiovascular disease; Lipid-lowering drugsRecomanació Essencial sobre “Fibrats en la prevenció primària de la malaltia cardiovascular”, per la qual, no es recomana la prescripció rutinària de fibrats per a la prevenció primària de la malaltia cardiovascular. Essencial és un projecte de l'Agència de Qualitat i Avaluació Sanitàries de Catalunya del Departament de Salut per reduir o evitar les pràctiques clíniques de poc valor.Recomendación Essencial sobre "Fibrats en la prevenció primària de la malaltia cardiovascular”, por la cual no se recomienda la prescripción rutinaria de fibratos para la prevención primaria de la enfermedad cardiovascular. Essencial es un proyecto de la Agencia de Calidad y Evaluación Sanitarias de Cataluña del Departamento de Salud para reducir o evitar las prácticas clínicas de bajo valor.Essential Recommendation on “Fibrats en la prevenció primària de la malaltia cardiovascular,” which advises against the routine prescription of fibrates for the primary prevention of cardiovascular disease. Essencial is a project by the Catalan Agency for Health Quality and Assessment (AQuAS) under the Department of Health, aimed at reducing or avoiding low-value clinical practices

Evaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocols

Abstract Background Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016–2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5 M inhabitants). Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011–2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation. They reflect different implementation maturity levels. While full coverage of the entire urban health district of Barcelona-Esquerra (520 k inhabitants) is the main aim of home hospitalization, demonstration of sustainability at Hospital Clinic of Barcelona constitutes the core goal of the prehabilitation service. Likewise, full coverage of integrated care services addressed to frail chronic patients is aimed at the city of Badalona (216 k inhabitants). Methods The population-based analysis, as well as the three service-based protocols, follow observational and experimental study designs using a non-randomized intervention group (integrated care) compared with a control group (usual care) with a propensity score matching method. Evaluation of cost-effectiveness of the interventions using a Quadruple aim approach is a central outcome in all protocols. Moreover, multi-criteria decision analysis is explored as an innovative method for health delivery assessment. The following additional dimensions will also be addressed: i) Determinants of sustainability and scalability of the services; ii) Assessment of the technological support; iii) Enhanced health risk assessment; and, iv) Factors modulating service transferability. Discussion The current study offers a unique opportunity to undertake a comprehensive assessment of integrated care fostering deployment of services at regional level. The study outcomes will contribute refining service workflows, improving health risk assessment and generating recommendations for service selection. Trials registration NCT03130283 (date released 04/06/2018), NCT03768050 (date released 12/05/2018), NCT03767387 (date released 12/05/2018)

Evaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocols

Abstract Background Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016–2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5 M inhabitants). Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011–2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation. They reflect different implementation maturity levels. While full coverage of the entire urban health district of Barcelona-Esquerra (520 k inhabitants) is the main aim of home hospitalization, demonstration of sustainability at Hospital Clinic of Barcelona constitutes the core goal of the prehabilitation service. Likewise, full coverage of integrated care services addressed to frail chronic patients is aimed at the city of Badalona (216 k inhabitants). Methods The population-based analysis, as well as the three service-based protocols, follow observational and experimental study designs using a non-randomized intervention group (integrated care) compared with a control group (usual care) with a propensity score matching method. Evaluation of cost-effectiveness of the interventions using a Quadruple aim approach is a central outcome in all protocols. Moreover, multi-criteria decision analysis is explored as an innovative method for health delivery assessment. The following additional dimensions will also be addressed: i) Determinants of sustainability and scalability of the services; ii) Assessment of the technological support; iii) Enhanced health risk assessment; and, iv) Factors modulating service transferability. Discussion The current study offers a unique opportunity to undertake a comprehensive assessment of integrated care fostering deployment of services at regional level. The study outcomes will contribute refining service workflows, improving health risk assessment and generating recommendations for service selection. Trials registration NCT03130283 (date released 04/06/2018), NCT03768050 (date released 12/05/2018), NCT03767387 (date released 12/05/2018)

Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Abstract Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement

Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Abstract Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement