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Calabrò GE, Rumi F, Ricciardi R, Cicchetti A. The economic and fiscal impact of incremental use of cell-based quadrivalent influenza vaccine for the prevention of seasonal influenza among healthcare workers in Italy. Health Res Policy Syst 2024; 22:36. [PMID: 38519969 PMCID: PMC10960473 DOI: 10.1186/s12961-024-01122-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/17/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Seasonal influenza has a significant impact on public health, generating substantial direct healthcare costs, production losses and fiscal effects. Understanding these consequences is crucial to effective decision-making and the development of preventive strategies. This study aimed to evaluate the economic and the fiscal impact of implementing an incremental strategy for seasonal influenza prevention using the cell-based quadrivalent influenza vaccine (QIVc) among healthcare workers (HCWs) in Italy. METHODS To estimate the economic impact of implementing this strategy, we performed a cost analysis that considered direct healthcare costs, productivity losses and fiscal impact. The analysis considered a 3-year time horizon. A deterministic sensitivity analysis was also conducted. RESULTS Assuming a vaccination coverage rate of 30% among HCWs, the analysis considered a total of 203 018 vaccinated subjects. On analysing the overall differential impact (including direct costs, indirect costs and fiscal impact), implementing QIVc vaccination as a preventative measure against influenza among HCWs in Italy would yield societal resource savings of €23 638.78 in the first year, €47 277.56 in the second year, and €70 916.35 in the third year, resulting in total resource savings of €141 832.69. CONCLUSIONS The study demonstrated that implementing the incremental use of QIVc as part of a preventive strategy for seasonal influenza among HCWs in Italy could yield positive economic outcomes, especially in terms of indirect costs and fiscal impact. The resources saved could be utilized to fund further public health interventions. Policy-makers should consider these findings when making decisions regarding influenza prevention strategies targeting HCWs.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, L.Go F. Vito 1, 00168, Rome, Italy.
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
| | - Filippo Rumi
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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Domnich A, Calabrò GE. Epidemiology and burden of respiratory syncytial virus in Italian adults: A systematic review and meta-analysis. PLoS One 2024; 19:e0297608. [PMID: 38442123 PMCID: PMC10914269 DOI: 10.1371/journal.pone.0297608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/17/2024] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVE Respiratory syncytial virus (RSV) is a common respiratory pathogen not only in children, but also in adults. In view of a recent authorization of adult RSV vaccines in Italy, our research question was to quantify the epidemiology and burden of RSV in Italian adults. METHODS Observational studies on the epidemiology and clinical burden of laboratory-confirmed or record-coded RSV infection in Italian adults of any age were eligible. Studies with no separate data for Italian adults, modeling and other secondary publications were excluded. A literature search was performed in MEDLINE, Biological Abstracts, Global Health, Scopus and Web of Science on 22 November 2023. Critical appraisal was performed by means of a Joanna Briggs Institute checklist. Random-effects (RE) meta-analysis was performed to obtain pooled estimates and the observed heterogeneity was investigated by subgroup and meta-regression analyses. The protocol was prospectively registered (doi.org/10.17504/protocols.io.5qpvo32odv4o/v1). RESULTS Thirty-five studies were identified, most of which had at least one possible quality concern. RSV seasonal attack rates ranged from 0.8 ‰ in community-dwelling older adults to 10.9% in hematological outpatients. In the RE model, 4.5% (95% CI: 3.2-5.9%) of respiratory samples tested positive for RSV. This positivity prevalence was higher in older adults (4.4%) than in working-age adults (3.5%) and in outpatient (4.9%) than inpatient (2.9%) settings. According to the meta-regression, study location and sample size were also significant predictors of RSV detection frequency. The pooled estimate of in-hospital mortality was as high as 7.2% (95% CI: 4.7-10.3%). Data on other indicators of the diseases burden, such as complication and hospitalization rates, were unavailable. CONCLUSION RSV poses a measurable burden on Italian adults, especially those of older age and with some co-morbidities. However, several data on the natural history of RSV disease are missing and should be established by future large-scale studies.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Calabrò GE, Causio FA, Pires Marafon D, Sassano M, Moccia F, Pastorino R, Boccia S. Public attitudes, knowledge and educational needs toward genetic testing and omics sciences: a pilot survey conducted in Italy. Eur J Public Health 2024; 34:75-78. [PMID: 37889589 PMCID: PMC10843941 DOI: 10.1093/eurpub/ckad189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023] Open
Abstract
Advancements in genomics have significant implications for public health, making citizens' education vital for informed decision-making. Based on two literature reviews' findings and a survey conducted with experts from the Italian Network of Genomics in Public Health, we conducted a pilot survey on Italian citizens' attitudes, knowledge and educational needs toward genetic testing and omics sciences. Our results demonstrate a widespread interest in genetic testing and uncertainties regarding associated risks, with 99% of participants acknowledging insufficient knowledge of genetic testing. There is an urgent need for educational tools to improve citizens' literacy and engagement in this rapidly evolving field.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Andrea Causio
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Denise Pires Marafon
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michele Sassano
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Roberta Pastorino
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stefania Boccia
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Narducci ML, Nurchis MC, Ballacci F, Giordano F, Calabrò GE, Massetti M, Crea F, Aspromonte N, Damiani G. Cost-utility of cardiac contractility modulation in patients with heart failure with reduced ejection fraction in Italy. ESC Heart Fail 2024; 11:229-239. [PMID: 37943287 PMCID: PMC10804153 DOI: 10.1002/ehf2.14538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/08/2023] [Indexed: 11/10/2023] Open
Abstract
AIMS Cardiac contractility modulation (CCM) is a device therapy for heart failure, based on the delivery of high-voltage biphasic impulses to the right ventricular septum during the myocardial absolute refractory period. This study evaluated the cost-effectiveness of CCM therapy plus optimal medical therapy (OMT) vs. OMT alone in patients with heart failure with reduced ejection fraction. METHODS AND RESULTS A Markov model with a lifespan time horizon was developed to assess the cost-utility using the FIX trials as main data sources. A deterministic sensitivity analysis and a probabilistic sensitivity analysis were run to analyse the decision uncertainty in the model through cost-effectiveness acceptability curve (CEAC) and cost-effectiveness acceptability frontier (CEAF). Value of information analysis was also conducted computing the expected value of perfect information (EVPI) and the expected value of partial perfect information. The base case results showed that the CCM plus OMT option was highly cost-effective compared with OMT alone with an incremental cost-utility ratio of €7034/quality-adjusted life year (QALY). The CEAC and CEAF illustrated that for all willingness to pay levels above €5600/QALY, tested up to €50 000/QALY, CCM plus OMT alternative had the highest probability of being cost-effective. The EVPI per patient was estimated to be €124 412 on a willingness to pay threshold of €30 000/QALY. CONCLUSIONS For patients with heart failure with reduced ejection fraction, CCM therapy could be cost-effective when taking a lifetime horizon. Further long-term, post-approval clinical studies are needed to verify these results in a real-world context, particularly concerning the effect of CCM therapy on mortality.
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Affiliation(s)
- Maria Lucia Narducci
- Department of Cardiovascular and Thoracic SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Mario Cesare Nurchis
- Section of Hygiene, Department of Health Science and Public HealthUniversità Cattolica del Sacro CuoreRomeItaly
- Department of Woman and Child Health and Public HealthFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Federico Ballacci
- Department of Cardiovascular and Thoracic SciencesUniversità Cattolica del Sacro CuoreRomeItaly
| | - Federica Giordano
- Department of Cardiovascular and Thoracic SciencesUniversità Cattolica del Sacro CuoreRomeItaly
| | - Giovanna Elisa Calabrò
- Section of Hygiene, Department of Health Science and Public HealthUniversità Cattolica del Sacro CuoreRomeItaly
- Value in Health Technology and Academy for Leadership & Innovation (VIHTALI), Spin‐Off of Università Cattolica del Sacro CuoreRomeItaly
| | - Massimo Massetti
- Department of Cardiovascular and Thoracic SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Cardiovascular and Thoracic SciencesUniversità Cattolica del Sacro CuoreRomeItaly
| | - Filippo Crea
- Department of Cardiovascular and Thoracic SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Cardiovascular and Thoracic SciencesUniversità Cattolica del Sacro CuoreRomeItaly
| | - Nadia Aspromonte
- Department of Cardiovascular and Thoracic SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Gianfranco Damiani
- Section of Hygiene, Department of Health Science and Public HealthUniversità Cattolica del Sacro CuoreRomeItaly
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Orsini F, D’Ambrosio F, Scardigno A, Ricciardi R, Calabrò GE. Epidemiological Impact of Metabolic Syndrome in Overweight and Obese European Children and Adolescents: A Systematic Literature Review. Nutrients 2023; 15:3895. [PMID: 37764679 PMCID: PMC10536523 DOI: 10.3390/nu15183895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
The prevalence of overweight and obesity is continuously increasing, both in the adult and pediatric populations, posing a substantial challenge to public health. Understanding the epidemiological burden of metabolic syndrome (MetS) among children, particularly regarding its complications and long-term effects in adulthood, is crucial for identifying effective preventive measures and enhancing the clinical care of obese children. Therefore, by searching two databases, a systematic review was conducted in order to evaluate studies that specifically addressed the epidemiological MetS impact among overweight/obese European children and adolescents. Overall, 15 studies were considered. The epidemiological data concerning the MetS impact were contingent on the diagnostic criteria used and varied across countries, resulting in a prevalence range of 1.44% to 55.8%. Spanish studies were the most numerous (34%), revealing a country prevalence rate ranging from 2.5% to 19.6%. Males (prevalence range: 1.4-55.8%) and subjects with overweight/obesity (prevalence range: 12.9-55.8%) were mainly affected. Obesity emerged as the main risk factor in the MetS development and the consequent onset of cardiovascular complications and diabetes. Knowing the MetS burden and its risk factors could improve their prevention, detection, and treatment, and guide the development of targeted public health interventions to appropriately address the health needs of younger patients.
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Affiliation(s)
- Francesca Orsini
- Laboratory of Pharmacoepidemiology and Human Nutrition, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy;
| | - Floriana D’Ambrosio
- Section of Hygiene, Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, L.go F. Vito 1, 00168 Rome, Italy; (A.S.); (G.E.C.)
| | - Anna Scardigno
- Section of Hygiene, Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, L.go F. Vito 1, 00168 Rome, Italy; (A.S.); (G.E.C.)
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, L.go F. Vito 1, 00168 Rome, Italy; (A.S.); (G.E.C.)
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
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Calabrò GE, Pappalardo C, D'Ambrosio F, Vece M, Lupi C, Lontano A, Di Russo M, Ricciardi R, de Waure C. The Impact of Vaccination on COVID-19 Burden of Disease in the Adult and Elderly Population: A Systematic Review of Italian Evidence. Vaccines (Basel) 2023; 11:vaccines11051011. [PMID: 37243115 DOI: 10.3390/vaccines11051011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023] Open
Abstract
COVID-19 is a major global health threat, with millions of confirmed cases and deaths worldwide. Containment and mitigation strategies, including vaccination, have been implemented to reduce transmission and protect the population. We conducted two systematic reviews to collect nonrandomized studies investigating the effects of vaccination on COVID-19-related complications and deaths in the Italian population. We considered studies conducted in Italian settings and written in English that contained data on the effects of vaccination on COVID-19-related mortality and complications. We excluded studies that pertained to the pediatric population. In total, we included 10 unique studies in our two systematic reviews. The results showed that fully vaccinated individuals had a lower risk of death, severe symptoms, and hospitalization compared to unvaccinated individuals. The review also looked at the impact of vaccination on post-COVID-19 syndrome, the effectiveness of booster doses in older individuals, and nationwide adverse events. Our work highlights the crucial role that vaccination campaigns have played in reducing the burden of COVID-19 disease in the Italian adult population, positively impacting the pandemic trajectory in Italy.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ciro Pappalardo
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Floriana D'Ambrosio
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Michele Vece
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Chiara Lupi
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Alberto Lontano
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Mattia Di Russo
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
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Refolo P, Sacchini D, Raimondi C, Calabrò GE, Spagnolo AG. What Type of Person Should I Be? About the Appeal to Virtues in Public Health Interventions. Vaccines (Basel) 2023; 11:vaccines11040767. [PMID: 37112679 PMCID: PMC10146751 DOI: 10.3390/vaccines11040767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
In line with how ethics has developed for the last three centuries, public health ethics has been widely dominated by a deontological as well as a utilitarian approach. The latter is a version of consequentialism, which states that maximizing utility is the primary goal of the majority of individuals or group action, while, on the other hand, virtue ethics, or at least the appeal to virtues, has been largely marginalized. The aim of this article is twofold. Firstly, we aim to highlight the political and ethical nature of public health interventions, often interpreted and presented as mere scientific enterprises. Secondly, we try to highlight the need to integrate or at least recognize the value of appeal to virtues in public health measures. The analysis will reference the Italian COVID-19 vaccination program as a case study. Initially, we will explore the political and ethical nature of any public health measure, using the implementation of the COVID-19 vaccination program in Italy as an example. Subsequently, we will illustrate the deontological approach to ethics, the utilitarian one, and the virtues one, focusing on the dynamic of the agent’s perspective. Lastly, we will briefly analyze both the Italian COVID-19 vaccination program and the communication campaign that promoted it.
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Affiliation(s)
- Pietro Refolo
- Section of Bioethics and Medical Humanities, Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (C.R.)
- Research Center for Clinical Bioethics and Medical Humanities, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Dario Sacchini
- Section of Bioethics and Medical Humanities, Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (C.R.)
- Research Center for Clinical Bioethics and Medical Humanities, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Correspondence:
| | - Costanza Raimondi
- Section of Bioethics and Medical Humanities, Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (C.R.)
- Research Center for Clinical Bioethics and Medical Humanities, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Gioacchino Spagnolo
- Section of Bioethics and Medical Humanities, Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (C.R.)
- Research Center for Clinical Bioethics and Medical Humanities, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
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D’Ambrosio F, Pappalardo C, Scardigno A, Maida A, Ricciardi R, Calabrò GE. Peristomal Skin Complications in Ileostomy and Colostomy Patients: What We Need to Know from a Public Health Perspective. Int J Environ Res Public Health 2022; 20:ijerph20010079. [PMID: 36612395 PMCID: PMC9819694 DOI: 10.3390/ijerph20010079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Peristomal skin complications (PSCs) are the most common skin problems seen after ostomy surgery. They have a considerable impact on a patient's quality of life and contribute to a higher cost of care. METHODS A systematic review was conducted, querying three databases. The analysis was performed on international studies focused on the clinical-epidemiological burden of PSCs in adult patients with ileostomy/colostomy. RESULTS Overall, 23 studies were considered. The main diseases associated with ostomy surgery were rectal, colon and gynecological cancers, inflammatory bowel diseases, diverticulitis, bowel obstruction and intestinal perforation. Erythema, papules, skin erosions, ulcers and vesicles were the most common PSCs for patients with an ostomy (or stoma). A PSCs incidence ranging from 36.3% to 73.4% was described. Skin complications increased length of stay (LOS) and rates of readmission within 120 days of surgery. CONCLUSIONS PSCs data are still limited. A knowledge of their burden is essential to support health personnel and decision-makers in identifying the most appropriate responses to patients' needs. Proper management of these complications plays a fundamental role in improving the patient's quality of life. A multidisciplinary approach, as well as increased patient education and their empowerment, are priority measures to be implemented to foster a value-based healthcare.
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Affiliation(s)
- Floriana D’Ambrosio
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ciro Pappalardo
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Anna Scardigno
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ada Maida
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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9
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Calabrò GE, Boccalini S, Bechini A, Panatto D, Domnich A, Lai PL, Amicizia D, Rizzo C, Pugliese A, DI Pietro ML, Zanella B, Parente F, Trombetta CS, Saraceno G, Sottile S, Abreha FM, Giacchetta I, Properzi S, Santolini G, D'Ambrosio F, Maida A, Scardigno A, LA Gatta E, Petrella L, Bonanni P, DE Waure C. [Health Technology Assessment: a value-based tool for the evaluation of healthcare technologies. Reassessment of the cell-culture-derived quadrivalent influenza vaccine: Flucelvax Tetra ® 2.0]. J Prev Med Hyg 2022; 63:E1-E140. [PMID: 37034835 PMCID: PMC10079375 DOI: 10.15167/2421-4248/jpmh2022.63.4s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Affiliation(s)
- Giovanna Elisa Calabrò
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), Spin-off dell'Università Cattolica del Sacro Cuore, Roma, Italia
| | - Sara Boccalini
- Dipartimento di Scienze della Salute, Università degli di Studi di Firenze, Firenze, Italia
| | - Angela Bechini
- Dipartimento di Scienze della Salute, Università degli di Studi di Firenze, Firenze, Italia
| | - Donatella Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
- Centro Interuniversitario di Ricerca sull'Influenza e le altre Infezioni Trasmissibili (CIRI-IT), Genova, Italia
| | | | - Piero Luigi Lai
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
- Centro Interuniversitario di Ricerca sull'Influenza e le altre Infezioni Trasmissibili (CIRI-IT), Genova, Italia
| | - Daniela Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
- Centro Interuniversitario di Ricerca sull'Influenza e le altre Infezioni Trasmissibili (CIRI-IT), Genova, Italia
| | - Caterina Rizzo
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università degli Studi di Pisa, Pisa, Italia
| | - Andrea Pugliese
- Dipartimento di Matematica, Università di Trento, Trento, Italia
| | - Maria Luisa DI Pietro
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Beatrice Zanella
- Dipartimento di Scienze della Salute, Università degli di Studi di Firenze, Firenze, Italia
| | - Flavio Parente
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | | | | | - Sara Sottile
- Dipartimento di Matematica, Università di Trento, Trento, Italia
| | - Fasika Molla Abreha
- Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Irene Giacchetta
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - Sara Properzi
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - Giulia Santolini
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - Floriana D'Ambrosio
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Ada Maida
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Anna Scardigno
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Emanuele LA Gatta
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Luigi Petrella
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Paolo Bonanni
- Dipartimento di Scienze della Salute, Università degli di Studi di Firenze, Firenze, Italia
| | - Chiara DE Waure
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
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10
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Regazzi L, Marziali E, Lontano A, Villani L, Paladini A, Calabrò GE, Laurenti P, Ricciardi W, Cadeddu C. Knowledge, attitudes, and behaviors toward COVID-19 vaccination in a sample of Italian healthcare workers. Hum Vaccin Immunother 2022; 18:2116206. [PMID: 36197125 PMCID: PMC9746397 DOI: 10.1080/21645515.2022.2116206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/29/2022] [Accepted: 08/10/2022] [Indexed: 12/15/2022] Open
Abstract
Vaccine hesitancy in healthcare workers (HCWs) has been studied for various contagious diseases, but there is still insufficient knowledge about this phenomenon for COVID-19. We developed and validated a knowledge, attitude, and practice survey of 39 questions to assess Italian HCWs' hesitancy toward vaccination in general (general hesitancy), COVID-19 vaccination (COVID-19 hesitancy), and public health injunctive measures (refusal of obligations). The survey was administered through a web platform between July and November 2021. Three multivariable logistic regressions were performed to evaluate the association between the explored dimensions of hesitancy and the potential determinants investigated. Out of 2,132 respondents with complete answers, 17.0% showed to be generally hesitancy toward vaccination, 32.3% were hesitant on COVID-19 vaccination, while 18.8% were categorized as refusing obligations. A significant protective effect against all three dimensions of hesitancy was found for increasing fear of COVID-19, advising COVID-19 vaccination to relatives and patients, having received flu vaccination in the previous year and having higher levels of education. Better self-rated knowledge about COVID-19 vaccines and reading up institutional sources were significantly protective against general and COVID-19 hesitancy, while being a physician rather than another healthcare professional was protective only against COVID-19 hesitancy. Conversely, increasing age and referring to colleagues to expand knowledge about COVID-19 were positively associated with COVID-19 hesitancy. The determinants of general hesitancy, COVID-19 hesitancy and the refusal of obligations are mostly overlapping. Given the great influence they exert on patients and communities, it is pivotal to limit HCWs vaccine hesitancy through appropriate training activities.
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Affiliation(s)
- Luca Regazzi
- Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eleonora Marziali
- Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alberto Lontano
- Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, Rome, Italy
| | - Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Paladini
- Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, Rome, Italy
| | - Patrizia Laurenti
- Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Women, Children and Public Health — Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, Rome, Italy
| | - Chiara Cadeddu
- Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, Rome, Italy
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11
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Calabrò GE, Riccardi MT, D'Ambrosio F, Castagna C, Sapienza M, Millevolte R, Pellacchia A, Ricciardi R, de Vincenzo RP, de Waure C. Cervical cancer elimination in Italy: Current scenario and future endeavors for a value based prevention. Front Public Health 2022; 10:1010237. [PMID: 36530690 PMCID: PMC9747937 DOI: 10.3389/fpubh.2022.1010237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
Background Cervical Cancer (CC) is a vaccine-preventable disease, and it is treatable if diagnosed early and managed properly. However, it is the fourth most common cancer in women worldwide with about 604,127 cases and 341,831 deaths in 2020. In Italy, it represents the fifth most common cancer in women under 50 years of age with about 2,400 new cases in 2020. The CC elimination is today a global public health goal published by the World Health Organization (WHO) in 2020 and a commitment of the European Union that has included it in Europe's Beating Cancer Plan. Therefore, urgent action is needed, at international and national level, to implement value-based interventions regarding vaccination, screening and timely management of the disease. Our study aims to describe the state of the art of Human Papilloma Virus (HPV) prevention in Italy and to get a consensus on indicators for monitoring the progress toward CC elimination at national level. Methods The study envisaged the following activities: research and synthesis of the evidence on strategies and actions for CC elimination at regional Italian level; identification of indicators to monitor such strategies/actions; organization of a multi-stakeholder consensus to reach the agreement on main indicators to be used in Italy. Results As for HPV vaccination coverage, the last Italian available data (December 31st, 2020) showed that it was way below the target (95%) with full cycle vaccination coverage ranging from 6 to 61.7% in female adolescents and from 5.4 to 55.4% in male adolescents (2008 birth cohorts). The coverage rate of CC screening is variable with a range of 61.7-89.6%. Furthermore, coverage rates due to organized screening programs (excluding out-of-pocket screening) shows a range from 20.7 to 71.8%. The mapping of the Italian Regions highlighted an important regional heterogeneity in respect to organizational/operational issue of HPV vaccination and CC screening. Indicators for monitoring CC elimination strategies have been drawn from the Australian experience and distinguished by disease outcomes, vaccination coverage, screening participation and treatment uptake. The highest consensus was reached for the following indicators: CC incidence; detection of high-grade cervical disease; CC mortality; full cycle vaccination coverage; screening participation; high-grade cervical disease treatment rates; CC treatment rates. Conclusions The assessment of the current status of CC elimination as overarching goal beyond the achievement of vaccine, screening and treatment targets represents the first step for the identification of interventions to be implemented to accelerate the path toward CC elimination. Based on this and following the WHO call, a value-based approach is proposed to untangle the full benefit of HPV-related cancers elimination strategies and identify priority and best practices.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- VIHTALI Value in Health Technology and Academy for Leadership and Innovation, Spin Off of Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Teresa Riccardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Floriana D'Ambrosio
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carolina Castagna
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Sapienza
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Andrea Pellacchia
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Roberto Ricciardi
- VIHTALI Value in Health Technology and Academy for Leadership and Innovation, Spin Off of Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rosa Pasqualina de Vincenzo
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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12
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Marziali E, Lontano A, Regazzi L, Paladini A, Villani L, Calabrò GE, Damiani G, Laurenti P, Ricciardi W, Cadeddu C. Factors Influencing the Choice to Advise for or against COVID-19 Vaccination in the Physicians and Dentists of an Italian Region. Vaccines (Basel) 2022; 10:1793. [PMID: 36366302 PMCID: PMC9696475 DOI: 10.3390/vaccines10111793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 09/19/2023] Open
Abstract
Healthcare workers (HCWs), particularly physicians, are a relevant and trusted source of information for patients, especially when health-related choices such as vaccination are concerned. Between July and November 2022, we administered a web-based survey to physicians and dentists living in the Latio region of Italy to explore whether their background might affect their willingness to recommend the COVID-19 vaccination to their patients (RCVtoPat) and their relatives (RCVtoRel). We performed a multivariable logistic regression to study the association between the two outcomes (RCVtoPat and RCVtoRel) and their potential determinants in our sample (n = 1464). We found that being a dentist, an increasing fear of COVID-19, and having been previously vaccinated against flu are positively associated with both RCVtoPat and RCVtoRel, while a better self-rated knowledge of COVID-19 vaccines is associated only with RCVtoRel. No role was found for age, sex, civil status, education level, information sources, previous SARS-CoV-2 infection, and chronic diseases. A sub-group analysis of physicians alone (n = 1305) demonstrated a positive association with RCVtoRel of being specialized in diagnostic/therapeutic services and a negative effect on RCVtoPat of being trained in general practice. We provide useful insights about the factors that should be addressed to ensure HCWs exert a positive influence on their patients and communities.
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Affiliation(s)
- Eleonora Marziali
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alberto Lontano
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Regazzi
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Paladini
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gianfranco Damiani
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Women, Children and Public Health—Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Patrizia Laurenti
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Women, Children and Public Health—Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Chiara Cadeddu
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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13
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D'Ambrosio F, Orsini F, Scardigno A, Pappalardo C, Ricciardi R, Calabrò GE. The frequency of UTIs in people who undertake intermittent catheterization: A systematic review. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Intermittent Catheterization (IC) is a common procedure used for the management of incomplete bladder emptying in various diseases such as spinal cord injury, multiple sclerosis and benign prostatic hypertrophy. Catheterization is associated with several complications and particularly with an increased risk of developing urinary tract infections (UTIs) responsible for high morbidity worldwide and significant costs to health systems and society.Today, this health problem is still underestimated. Therefore, the aim of this study was to summarize the available evidence on the clinical and epidemiological burden of UTIs among patients performing IC.
Methods
A systematic literature review was performed querying two online database (PubMed,Web of Science) from January 2012 to January 2022. All studies in English language and focused on the clinical-epidemiological burden of UTIs related to IC in the adult population were included.
Results
Overall, 43 studies were considered. It was described a range of UTIs from 26% to 63%, with an increased number of hospital admissions and length of stay. UTIs were more common in patients with spinal cord injuries (about 40%) and with multiple sclerosis (24-34%).The main risk factors associated with UTIs were catheter reuse, type of catheter and catheterization procedure adopted.
Conclusions
Data on IC-associated UTIs are still limited. Estimating the UTIs load in patients with IC could support healthcare professionals to identify the most appropriate type of catheter to reduce the risk of this important complication. Proper management of catheterization could improve patients’ quality of life and also reduce the impact of diseases associated with this procedure on health systems and society.
Key messages
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Affiliation(s)
- F D'Ambrosio
- Section of Hygiene, University Department of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - F Orsini
- Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore , Rome, Italy
| | - A Scardigno
- Section of Hygiene, University Department of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - C Pappalardo
- Section of Hygiene, University Department of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - R Ricciardi
- VIHTALI, Spin-Off of Università Cattolica del Sacro Cuore , Rome, Italy
| | - GE Calabrò
- Section of Hygiene, University Department of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
- VIHTALI, Spin-Off of Università Cattolica del Sacro Cuore , Rome, Italy
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14
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de Waure C, Calabrò GE, Ricciardi W. A perspective on the assessment of the broad value of vaccinations. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Vaccinations are considered a cost-effective public health intervention to control vaccine-preventable diseases and are commonly evaluated in respect to several domains, including efficacy, safety and cost-effectiveness, before being implemented nationwide. There are plenty of evidence of economic evaluations performed on single vaccines or vaccinations. They commonly relies on static or dynamic models and considers both direct and indirect costs, i.e., those linked to productivity loss, of vaccine-preventable diseases. Nevertheless, vaccinations are expected to provide also societal benefits that call to the development and implementation of methods to value them, also from an economic point of view. The scientific debate on the assessment of the broad value of vaccinations has pinpointed several relevant aspects that need to be paid attention in future evaluations. They include the antibiotic sparing effect of vaccination, their impact on antimicrobial resistance - which is a challenge of our days -, their effect on social cohesion, their role in avoiding the loss of school days and in ameliorating educational attainment. The economic evaluation of vaccinations need to be further developed in order to allow a quantitative exploitation of their broad value according to the aspects described above. As the experience is still scant, we need to work on several fronts, including capacity building, data production and sharing and new methods development.
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Affiliation(s)
- C de Waure
- Department of Medicine and Surgery, University of Perugia , Perugia, Italy
| | - GE Calabrò
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - W Ricciardi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
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15
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D'Ambrosio F, Pappalardo C, Scardigno A, Maida A, Ricciardi R, Calabrò GE. Peristomal skin complications in ileostomy and colostomy patients: a systematic literature review. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Peristomal skin complications (PSCs) are one of the main post-operative complications of ostomy surgery. They have a considerable impact on patients’ quality of life and represent a challenge for healthcare professionals involved in their management. The majority of PSCs is preventable and costly. Knowing their burden could guide decision makers on the ostomy patients’ management who are predominantly cancer and chronic bowel disease patients. Thus, the aim of this study was to summarize existing literature regarding the clinical-epidemiological burden of PSCs in ostomy patients.
Methods
A systematic literature review was performed querying three database (PubMed, Scopus, Web of Science) from January 2012 to February 2022. It included studies in English language and focused on the clinical and epidemiological burden of PSCs in the adult patients with ileostomy and colostomy.
Results
Overall, 35 studies were considered. Epidemiological data on PSCs were not systematically collected in the available literature. The principal underlying disease requiring the ostomy surgery were rectal, colon and gynaecological cancers, inflammatory bowel diseases, diverticulitis, occlusion and intestinal perforation. It was described a range of PSCs from 11% to 45%. The PSCs were most commonly erythema, papules, erosion, ulceration and vesciculation. Skin complications increased the average number of hospitalization days and of hospital readmission within 120-day following surgery.
Conclusions
The data on PSCs are still limited. Estimating the PSCs burden could support healthcare professionals and decision makers called upon to identify the most appropriate responses to patients’ health needs. The management of these complications plays a vital role to improve patient’s quality of life and a multidisciplinary approach with the active involvement of stomatherapist, surgeon and dermatologist is critical. Furthermore, a better patient education and empowerment is needed.
Key messages
• Developing a multidisciplinary approach to managing PSCs is essential in order to provide the best treatment possible and the best outcomes for patients.
• Further studies should be conducted in order to better define the clinical-epidemiological burden of ileo- and colostomies and to support better health planning.
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Affiliation(s)
- F D'Ambrosio
- Section of Hygiene, University Department of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - C Pappalardo
- Section of Hygiene, University Department of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - A Scardigno
- Section of Hygiene, University Department of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - A Maida
- Section of Hygiene, University Department of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - R Ricciardi
- VIHTALI, Spin-Off of Università Cattolica del Sacro Cuore , Rome, Italy
| | - GE Calabrò
- Section of Hygiene, University Department of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
- VIHTALI, Spin-Off of Università Cattolica del Sacro Cuore , Rome, Italy
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16
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de Waure C, Riccardi MT, D'Ambrosio F, Castagna C, Sapienza M, Millevolte R, Pellacchia A, de Vincenzo RP, Calabrò GE. Walk the path of cervical cancer elimination in Italy: current scenario and shared recommendations. Eur J Public Health 2022. [PMCID: PMC9594223 DOI: 10.1093/eurpub/ckac131.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Issue/problem In 2020, the World Health Organization (WHO) called for the elimination of cervical cancer. In order to get it, vaccination against Human Papillomavirus (HPV), screening of cervical cancer and treatment of high-grade cervical disease and cancer must be implemented at country level. Description of the problem Italy has implemented HPV vaccination and cervical cancer screening for many years. Nevertheless, nationwide data show that both vaccination coverage and adherence to screening programs are unsatisfactory as compared to the WHO 90 and 70 targets, namely 90% of girls fully vaccinated by the age of 15 years and 70% of women screened with a high-performance test (i.e., HPV-DNA test) by age 35 and again by 45. Results In order to address the progress of vaccination and screening at regional level in Italy, a project was conducted in 2021-2022 in order to collect data on relevant indicators and issues. In particular, information was collected on both coverage indicators (for both vaccination and screening) adherence (for screening) and history and characteristics of the vaccination offer (e.g., targets, gratuity) and of screening (e.g., presence of clinical pathways, type of tests used). Collected data were shared with a multidisciplinary panel of experts on HPV-related diseases to issue recommendations to foster the elimination of cervical cancer in Italy. For this purpose, a survey was also conducted to identify potential actions in respect to vaccination, screening and treatment. Lessons A great heterogeneity across Italian regions was observed. The following actions were identified to implement vaccination, screening and treatment: educational campaigns, reminders and active calls for both vaccination and screening and more interoperability of data and definition of clinical pathway involving a multidisciplinary medical team for the proper management of all HPV-related diseases. Key messages • Actions are requested at national level to achieve the goals set by the global strategy for cervical cancer elimination with respect to vaccination, screening and treatment. • Actions identified to foster cervical cancer elimination in Italy includes educational campaigns, reminders and active calls, better interoperability of data and integrated medical team.
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Affiliation(s)
- C de Waure
- Department of Medicine and Surgery, University of Perugia , Perugia, Italy
| | - MT Riccardi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - F D'Ambrosio
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - C Castagna
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - M Sapienza
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - R Millevolte
- Department of Medicine and Surgery, University of Perugia , Perugia, Italy
| | - A Pellacchia
- Department of Medicine and Surgery, University of Perugia , Perugia, Italy
| | - RP de Vincenzo
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli , Rome, Italy
| | - GE Calabrò
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
- VIHTALI spin-off, Università Cattolica del Sacro Cuore , Rome, Italy
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17
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Calabrò GE, Rumi F, Fallani E, Ricciardi R, Cicchetti A. The Economic and Fiscal Impact of Influenza Vaccination for Health Care Workers in Italy. Vaccines (Basel) 2022; 10:vaccines10101707. [PMID: 36298572 PMCID: PMC9609125 DOI: 10.3390/vaccines10101707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/08/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Influenza has a significant impact on the health care system and also on production and economic systems. Vaccinated health care workers (HCWs) are more likely to have improved productivity compared to unvaccinated workers. The study aim was to estimate the economic and fiscal impact of an influenza vaccination program for HCWs in Italy. We performed a cost analysis aimed to estimate the indirect costs (productivity losses due to working days lost) and the increase in tax revenues derived from the increase in vaccination coverage among HCWs. Assuming an incremental increase in vaccination coverage of 10% per year over a period of 5 years, total savings could be obtained in terms of a reduction in productivity losses equal to −€4,475,497.16 and an increase in tax revenues of €327,158.84. This revenue could be used to finance other health interventions. Our results are fundamental in view of the sustainability of health systems and of a value-based allocation of health resources. Therefore, a complete social perspective, including the fiscal impact of flu vaccination, should be adopted to assess the economic value of influenza vaccines. Currently, health policies based on the whole value of flu vaccination are needed.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Filippo Rumi
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Elettra Fallani
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
- Seqirus S.r.l., 53035 Monteriggioni, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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18
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Calabrò GE, D’Ambrosio F, Fallani E, Ricciardi W. Influenza Vaccination Assessment according to a Value-Based Health Care Approach. Vaccines (Basel) 2022; 10:vaccines10101675. [PMID: 36298540 PMCID: PMC9612276 DOI: 10.3390/vaccines10101675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/02/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Seasonal influenza has a considerable public health impact, and vaccination is the key to preventing its consequences. Our aim was to describe how the value of influenza vaccination is addressed in the scientific literature considering a new value framework based on four pillars (personal, allocative, technical, and societal value). Methods: A systematic review was conducted by querying three databases. The analysis was performed on international studies focused on influenza vaccination value, and the four value pillars were taken into consideration for their description. Results: Overall, 40 studies were considered. Most of them focused on influenza vaccination in the general population (27.5%), emphasizing its value for all age groups. Most studies addressed technical value (70.4%), especially in terms of economic models and cost drivers to be considered for the economic evaluations of influenza vaccines, and societal value (63%), whereas few dealt with personal (37%) and allocative values (22.2%). Conclusions: The whole value of influenza vaccination is still not completely recognized. Knowledge and communication of the whole value of influenza vaccination is essential to guide value-based health policies. To achieve this goal, it is necessary to implement initiatives that involve all relevant stakeholders.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spinoff of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Floriana D’Ambrosio
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Elettra Fallani
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
- Seqirus S.R.L., Via del Pozzo 3/A, San Martino, 53035 Monteriggioni, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Calabrò GE, Basile M, Varano M, Amore F, Ricciardi R, Bandello F, Cicchetti A. Economic Aspects in the Management of Diabetic Macular Edema in Italy. Front Public Health 2022; 10:938987. [PMID: 35937268 PMCID: PMC9353644 DOI: 10.3389/fpubh.2022.938987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDiabetic Macular Edema (DME) is the most common cause of vision loss in diabetic patients. Currently, the Vascular Endothelial Growth Factor inhibitors (anti-VEGFs) are used as the first line of DME treatment and corticosteroid implants are usually used as a second-line treatment. These implants are a safe and effective therapeutic option that can improve the quality of life of DME patients by reducing the intravitreal injections number. We determined the economic impact related to DME, also from the social perspective, and the consequences of the increased use of the dexamethasone implant.MethodsThe analysis compares two scenarios: the first based on the current rate of recourse to the therapeutic alternatives available in the Italian healthcare setting (as is) and the second based on the assumption of an increased recourse to dexamethasone implants (to be). The results are expressed both in terms of the resource absorption associated with the two scenarios and in terms of the cost differential yielded by their comparison.ResultsThe increased use of the dexamethasone implant allows considerable savings in terms of healthcare professionals' time, follow-up and productivity lost by patients/caregivers. These savings would reduce healthcare costs for the management of DME patients in Italy by €2,058,238 in 5 years.ConclusionsTo optimize the healthcare resources allocation, it is necessary to implement treatments that yield not only cost reductions but also a clinical benefit for patients. The dexamethasone implant use is an example of DME management that generates value for patients, health system and society.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership and Innovation), Spin-Off of Università Cattolica del Sacro Cuore, Rome, Italy
- *Correspondence: Giovanna Elisa Calabrò
| | - Michele Basile
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Filippo Amore
- IAPB Italia Onlus - Polo Nazionale di Servizi e Ricerca per la Prevenzione della Cecità e la Riabilitazione Visiva, Centro di Collaborazione Organizzazione Mondiale Sanità Presso Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership and Innovation), Spin-Off of Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Bandello
- Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute, Milan, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy
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Villani L, D'Ambrosio F, Ricciardi R, Waure C, Calabrò GE. Seasonal influenza in children: Costs for the health system and society in Europe. Influenza Other Respir Viruses 2022; 16:820-831. [PMID: 35429133 PMCID: PMC9343336 DOI: 10.1111/irv.12991] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/29/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Floriana D'Ambrosio
- Section of Hygiene, University Department of Life Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation) Spin‐Off of Università Cattolica del Sacro Cuore Rome Italy
| | - Chiara Waure
- Department of Medicine and Surgery University of Perugia Perugia Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation) Spin‐Off of Università Cattolica del Sacro Cuore Rome Italy
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Calabrò GE, Boccalini S, Panatto D, Rizzo C, Di Pietro ML, Abreha FM, Ajelli M, Amicizia D, Bechini A, Giacchetta I, Lai PL, Merler S, Primieri C, Trentini F, Violi S, Bonanni P, de Waure C. The New Quadrivalent Adjuvanted Influenza Vaccine for the Italian Elderly: A Health Technology Assessment. Int J Environ Res Public Health 2022; 19:ijerph19074166. [PMID: 35409848 PMCID: PMC8998177 DOI: 10.3390/ijerph19074166] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/15/2022]
Abstract
Background. The elderly, commonly defined as subjects aged ≥65 years, are among the at-risk subjects recommended for annual influenza vaccination in European countries. Currently, two new vaccines are available for this population: the MF59-adjuvanted quadrivalent influenza vaccine (aQIV) and the high-dose quadrivalent influenza vaccine (hdQIV). Their multidimensional assessment might maximize the results in terms of achievable health benefits. Therefore, we carried out a Health Technology Assessment (HTA) of the aQIV by adopting a multidisciplinary policy-oriented approach to evaluate clinical, economic, organizational, and ethical implications for the Italian elderly. Methods. A HTA was conducted in 2020 to analyze influenza burden; characteristics, efficacy, and safety of aQIV and other available vaccines for the elderly; cost-effectiveness of aQIV; and related organizational and ethical implications. Comprehensive literature reviews/analyses were performed, and a transmission model was developed in order to address the above issues. Results. In Italy, the influenza burden on the elderly is high and from 77.7% to 96.1% of influenza-related deaths occur in the elderly. All available vaccines are effective and safe; however, aQIV, such as the adjuvanted trivalent influenza vaccine (aTIV), has proved more immunogenic and effective in the elderly. From the third payer’s perspective, but also from the societal one, the use of aQIV in comparison with egg-based standard QIV (eQIV) in the elderly population is cost-effective. The appropriateness of the use of available vaccines as well as citizens’ knowledge and attitudes remain a challenge for a successful vaccination campaign. Conclusions. The results of this project provide decision-makers with important evidence on the aQIV and support with scientific evidence on the appropriate use of vaccines in the elderly.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50121 Florence, Italy; (S.B.); (A.B.); (P.B.)
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (D.P.); (D.A.); (P.L.L.)
| | - Caterina Rizzo
- Clinical Pathways and Epidemiology Unit-Medical Direction, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Maria Luisa Di Pietro
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Fasika Molla Abreha
- Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN 47405, USA;
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (D.P.); (D.A.); (P.L.L.)
| | - Angela Bechini
- Department of Health Sciences, University of Florence, 50121 Florence, Italy; (S.B.); (A.B.); (P.B.)
| | - Irene Giacchetta
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
| | - Piero Luigi Lai
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (D.P.); (D.A.); (P.L.L.)
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, 38122 Trento, Italy; (S.M.); (F.T.)
| | - Chiara Primieri
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
| | - Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, 38122 Trento, Italy; (S.M.); (F.T.)
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, 20136 Milan, Italy
| | - Sara Violi
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50121 Florence, Italy; (S.B.); (A.B.); (P.B.)
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
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Hoxhaj I, Castagna C, Calabrò GE, Boccia S. HTA Training for Healthcare Professionals: International Overview of Initiatives Provided by HTA Agencies and Organizations. Front Public Health 2022; 10:795763. [PMID: 35223734 PMCID: PMC8866233 DOI: 10.3389/fpubh.2022.795763] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundHealth Technology Assessment (HTA) is a multidisciplinary process that synthesizes, with a systematic, transparent, impartial and robust methodological approach, the main information on the medical, economic, ethical and social implications of the use and dissemination of a health technology. Its aim is to support decision-makers in identifying safe, effective, patient-centered and best-value health policies, in order to promote an equitable, efficient, and high-quality health system. Given the continued application of innovative technologies into clinical practice, healthcare professionals need to be able to adequately evaluate these technologies using evidence-based approaches such as HTA. Therefore, the implementation of training in HTA is crucial. The aim of this study was to investigate existing HTA training initiatives for healthcare professionals provided by international HTA agencies and organizations around the world.MethodsFrom March to November 2020, the websites of HTA agencies and organizations belonging to the European network for HTA (EUnetHTA) and to the International Network of Agencies for HTA (INAHTA), and the website of the HTA International (HTAi), were explored for identifying the HTA training initiatives directed to healthcare professionals. In addition, we screened the training initiatives proposed at European level by EUnetHTA as part of its Joint Actions and conducted in collaboration with its public-private partners. Specific keywords were searched in English and adapted to French, Portuguese, Spanish, Italian and German. Data extraction of the retrieved training initiatives was conducted from November 2020 to February 2021 and considered the following information: agency, country, website, coordinator, type of initiative, target, topic, main contents, and language.ResultsOut of 124 agencies/organizations/EUnetHTA public-private partners screened, only 21 provided training initiatives for healthcare professionals. A total of 55 training initiatives were analyzed, 85.5% of which were delivered at the European level and 14.5% at the international level. The countries with a greater number of courses were: Austria, Argentina, Spain, Portugal, and the United Kingdom. Twenty-one training initiatives focused on HTA application and methodology while 34 on specific HTA domains, particularly on the economic one. The technologies covered were mainly drugs.ConclusionsOur study revealed a limited number of HTA training programs targeting healthcare professionals. HTA supports the decision-making processes concerning the use and application of health technologies with scientific evidence. Indeed, training of healthcare professionals in this field should be a key driver in implementing evidence-based healthcare choices and through rigorous methodological approaches such as HTA, in order to ensure proper health governance and value-based application of technological innovations in clinical practice. Therefore, capacity building of healthcare professionals in this area should be enhanced by using appropriate and effective training initiatives and educational strategies.
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Affiliation(s)
- Ilda Hoxhaj
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Carolina Castagna
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- *Correspondence: Giovanna Elisa Calabrò
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Abstract
INTRODUCTION Health systems worldwide need to pay attention to both sustainability and quality. The explosion of health technologies represents a challenge for health systems' sustainability, and evidence-based tools should support resources allocation to guarantee a continuous quality improvement. The value-based approach could disentangle the full benefit of a health technology, and this is of utmost importance in the vaccination field because of several obstacles still existing in reaching optimal vaccination uptake. AREAS COVERED The paper conveys the evidence on the full value of vaccine(s)/vaccination based on the framework suggested by the Expert Panel on Effective Ways of Investing in Health of the European Commission. Indeed, evidence on the personal, technical, allocative, and societal value of vaccine(s)/vaccination published in the last decade was described as foundation of a following consultation with international experts of the field. The result was the issuing of recommendations for research, decision-making, and public engagement that aimed to drive a value-based decision-making on vaccination. EXPERT OPINION The development of vaccination programs based on the recognition of the full value of vaccine(s)/vaccination is essential. To achieve this goal, it is necessary to launch intersectoral and multidisciplinary research and implementation initiatives involving all relevant stakeholders.
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Affiliation(s)
- Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy.,VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy
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Calabrò GE, Sassano M, Moccia F, Gaudioso A, Ricciardi W, Boccia S. Citizens' knowledge and educational needs in the omics sciences field: results from an Italian survey. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Progress in genomics has crucial implications for public health. Therefore, a strategic line to define the promotion and governance of omics related innovation is necessary. In this context, citizens education is essential to allow appropriate decisions about their own health.
Objectives
As part of a project funded by the Italian Ministry of Health, we carried out in collaboration with an Italian civic organization (Cittadinanzattiva) a survey on citizens' attitude, knowledge, and educational needs in omics sciences field. On the basis of the results of two our literature reviews and of a survey with experts of the Italian Network of Genomics in Public Health (GENISAP), we developed an ad hoc questionnaire for citizens. It was developed in order to assess the current state of information on omics field in the Italian population. The survey was launched, through the Cittadinanzattiva channels, on October 29, 2020 and it was closed on April 15, 2021.
Results
As of April 2021, 359 responses have been collected. The average age of the participants was 46.04 ± 15.77 years. 73.5% of the participants had no knowledge of omics sciences and 66.6% of DTC-GTs. As regards the citizens' attitudes, 88.6% would change their lifestyle on the basis of the genetic tests results. 89.2% expressed doubts about the reliability of the information received through the media. Almost all believe that citizens are not adequately informed about omics sciences and DTC-GTs and that more training initiatives are necessary on these topics (omics sciences: 95.5%, DTC-GTs: 95%).
Conclusions
The omics sciences progress is linked to the need to develop a solid literacy of citizens. For this reason, effective tools of knowledge on the omics sciences field will have to be identified and implemented to improve citizens' literacy and engagement in this rapidly changing field.
Key messages
The progress of the omics sciences is related to the need to develop a solid literacy of citizens in order to enable them to make appropriate decisions about their own health. The current challenge is to identify effective methods of improving citizens' literacy and implementing them.
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Affiliation(s)
- GE Calabrò
- University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Sassano
- University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - W Ricciardi
- University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Boccia
- University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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de Waure C, Calabrò GE, Tognetto A, Carini E, Giacchetta I, Bonanno E, Mariani M, Ricciardi W, de Waure C. Evidence and recommendations for a value-based decision making on vaccinations. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue/problem
Vaccinations are one of the most successful public health measures and contribute to the achievement of Sustainable Development Goals. Despite this, there are still several challenges, such as poor resources, unequal access, and vaccine hesitancy. An exploitation of the full value of vaccinations could help contrasting them.
Description of the problem
A dual approach was followed to exploit full value of vaccinations. First, the four pillars of value pinpointed by the Expert Panel on Effective Ways of Investing in Health of the European Commission, namely personal, societal, allocative, and technical value, were considered to carry out a systematic review of available papers addressing the value of vaccinations. The synthesis of data was the submitted to a panel of international experts in vaccinations who gave inputs on recommendations to drive a value-based decision-making.
Results
Overall, 54 papers published from 2010 onwards addressed at least one pillar of value with most of them (83.3%) assessing a single one. Two-thirds of papers addressed the technical pillar, namely the economic value, in most cases without catching the broad economic implications. Very few studies addressed allocative and societal value highlighting the need to generate evidence to support the application of these pillars. Furthermore, some aspects of the allocative pillar, such as equity, accessibility, and appropriate use, were not addressed so far. Recommendations on research on full value of vaccinations, decision-making process and public engagement were eventually issued.
Lessons
The project allowed to apply for the first the value-based approach to vaccinations. This led to the identification of current gaps in the assessment of full value of vaccinations and to recommendations to foster a value-based decision-making. These results have international relevance because of the growing attention to the value-based approach for sustainable health systems.
Key messages
The full value of vaccinations need to be further investigated according to the four pillars pinpointed by the Expert Panel on Effective Ways of Investing in Health. Different actions could be promoted with respect to research, decision-making process and public engagement in order to exploit the full value of vaccination and drive a value-based decision-making.
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Affiliation(s)
- C de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - GE Calabrò
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- VIHTALI, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Tognetto
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Carini
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - I Giacchetta
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - E Bonanno
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - M Mariani
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - W Ricciardi
- Section of Hygiene, University Department of Life Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Regazzi L, Paladini A, Marziali E, Lontano A, Calabrò GE, Messina R, Laurenti P, Boccia S, Ricciardi W, Cadeddu C. Italian health workers’ knowledge, attitudes and behaviours towards COVID-19 vaccination. Eur J Public Health 2021. [PMCID: PMC8574302 DOI: 10.1093/eurpub/ckab165.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Vaccine hesitancy is the reluctance or refusal to be vaccinated. While it has been widely studied for various contagious diseases, there is still a lack of knowledge about this phenomenon for COVID-19, especially if health workers' hesitancy is considered. Methods An extensive review of the literature was conducted to identify the main determinants of vaccine hesitancy in health workers, as well as to find already validated surveys to evaluate the knowledge, attitudes and behaviors (KAB) of health workers towards vaccination, both in general and with specific regard to COVID-19. Building on the available information, a new survey was developed to assess the KAB of Italian health care workers towards COVID-19 vaccination after validation with a pilot study in a diverse sample of 30 Italian health workers. Results A new survey was validated to assess the KAB of health workers towards COVID-19 vaccination in Italian health workers. The survey requires about 6 minutes to complete and is composed of 30 questions, investigating different domains: socio-demographic and professional characteristics (6); health status (2); attitudes (11); behaviors (6); knowledge (4). The survey will be administered to a representative sample of at least 385 Italian health workers through the web platform SurveyMonkey in the period June-September 2021. Preliminary results will be available by the end of October 2021. Conclusions By analyzing KAB towards COVID-19 vaccination with a new tool, the magnitude and determinants of health worker's COVID-19 vaccine hesitancy will be evaluated to understand how to improve health workers' perception towards COVID-19 vaccination and, consequently, foster their positive influence on the general population. Key messages We explore the knowledge, attitudes and behaviors towards COVID-19 vaccination in all categories of health workers operating on the Italian territory to understand the reasons of vaccine hesitancy. Understanding the determinants of COVID-19 vaccine hesitancy in Italian health workers is necessary given their influence on the perception of the general population in Italy.
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Affiliation(s)
- L Regazzi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Paladini
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Marziali
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Lontano
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G E Calabrò
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Messina
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Laurenti
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S Boccia
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - W Ricciardi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Cadeddu
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Basile M, Calabrò GE, Ghelardi A, Ricciardi R, De Vincenzo R, Cicchetti A. HPV Vaccination in Women Treated for Cervical Intraepithelial Neoplasia: A Budget Impact Analysis. Vaccines (Basel) 2021; 9:816. [PMID: 34451941 PMCID: PMC8402448 DOI: 10.3390/vaccines9080816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/03/2021] [Accepted: 07/19/2021] [Indexed: 11/16/2022] Open
Abstract
Human Papillomavirus (HPV) is the most common sexually transmitted infection. Its progression is related to the development of malignant lesions, particularly cervical intraepithelial neoplasias (CINs). CINs correlate with a higher risk of premature births, and their excisional and ablative treatment further increases this risk in pregnant women. These complications are also correlated with higher healthcare costs for their management. In Italy, more than 26,000 new cases of CINs are estimated to occur yearly and their economic burden is significant. Therefore, the management of these conditions is a public health priority. Since HPV vaccination is associated with a reduced risk of relapse in women surgically treated for HPV-related injuries, we estimated the economic impact of extending HPV vaccination to this target population. This strategy would result in a significant reduction in the general costs of managing these women, resulting in an overall saving for the Italian Health Service of €155,596.38 in 5 years. This lower cost is due not only to the reduced incidence of CINs following vaccination, but also to the lower occurrence of preterm births. Extending HPV vaccination to this target population as part of a care path to be offered to women treated for HPV injuries is therefore desirable.
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Affiliation(s)
- Michele Basile
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.B.); (A.C.)
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Alessandro Ghelardi
- Azienda USL Toscana Nord-Ovest, UOC Ostetricia e Ginecologia, Ospedale Apuane, Via Enrico Mattei, 21, 54100 Massa, Italy;
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Rosa De Vincenzo
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, 00168 Rome, Italy;
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.B.); (A.C.)
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Sassano M, Calabrò GE, Boccia S. A Web Screening on Educational Initiatives to Increase Citizens' Literacy on Genomics and Genetics. Front Genet 2021; 12:637438. [PMID: 34306000 PMCID: PMC8292827 DOI: 10.3389/fgene.2021.637438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/25/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Population awareness and empowerment in omics sciences represent a fundamental driver to increase the adoption of evidence-based approaches in personalized medicine. In this context, a pivotal role is played by citizens' literacy, and educational initiatives carried out in this context are key assets to drive future effective interventions. With the present study, we summarized the educational initiatives conducted worldwide aimed at increasing citizens' literacy in omics sciences. Materials and Methods We conducted a web search of the educational initiatives aimed at improving citizens' literacy in omics sciences undertaken worldwide, by using three search engines (Google, Bing, and Yahoo Search), in English and in Italian languages. Results We identified five initiatives in Europe, 22 in non-European countries, and 13 in Italy. Overall, the majority (69%) were web-based initiatives, while 31% required in-person attendance. The online initiatives included web pages for reading, online lessons/courses, web portals, videos/short movies, animations, and apps for mobile devices. The residential initiatives, on the other hand, included exhibitions, seminars, courses, symposia, information stands in public places, guided visits to research laboratories, and interactive laboratories. All the initiatives were highly heterogeneous in terms of methodologies and the topics addressed. Discussion and Conclusion Overall, we identified a variety of initiatives aimed at improving citizens' literacy in omics sciences, with the largest majority carried out in the United States and being web-based. Our results showed heterogeneity among the initiatives as to the dealt topics and the adopted methods. Further research is needed, however, to quantitatively assess the effectiveness of educational initiatives to improve citizens' literacy in omics sciences.
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Affiliation(s)
- Michele Sassano
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefania Boccia
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Calabrò GE, Carini E, Tognetto A, Mancinelli S, Sarnari L, Colamesta V, Ricciardi W, de Waure C. Developing an Evidence-Based Tool for Planning and Evaluating Vaccination Strategies Aimed at Improving Coverage in Elderly and At-Risk Adult Population. Front Public Health 2021; 9:658979. [PMID: 34249833 PMCID: PMC8264188 DOI: 10.3389/fpubh.2021.658979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Vaccination coverages need to be constantly maintained and improved with the implementation of vaccination strategies. This paper describes the development of an evidence-based tool to guide their planning and evaluation. Methods: A scoping review was performed in MEDLINE and institutional websites to search for similar available tools. A first version of the tool was developed considering review results and a four-step method used for the control and continuous improvement of processes and products, namely the Deming cycle. A panel of eight experts was then involved in a Delphi study for the finalization of the tool that was eventually discussed in a face-to-face meeting. Results: The scoping review found only one document and the first version of the tool was composed of 30 items. After the Delphi first round, 11 additional items were suggested and 5 original items amended. After the Delphi second round 41 items were eventually included. During the face-to-face meeting, 7 items were recognized as requisites for setting vaccination strategies, whereas 17 as relevant ones. Conclusions: Current public health challenges impose the need for evidence-based tools to organize effective vaccination strategies. Our tool is a first proposal which aims to reflect this focus.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.,V.I.H.T.A.L.I. (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elettra Carini
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessia Tognetto
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Mancinelli
- Department of Pneumological Sciences, Section of Pneumology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Laura Sarnari
- Regional Health Unit Azienda Sanitaria Unica Regionale, Area Vasta 3, Sanitary District of Macerata, Macerata, Italy
| | - Vittoria Colamesta
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.,Unità Operativa Complessa Direzione Sanitaria S. Spirito e Nuovo Regina Margherita, Local Health Unit Azienda Sanitaria Locale Roma 1, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Calabrò GE, Tognetto A, Mazzaccara A, Barbina D, Carbone P, Guerrera D, Di Pucchio A, Federici A, Ricciardi W, Boccia S. Capacity Building of Health Professionals on Genetics and Genomics Practice: Evaluation of the Effectiveness of a Distance Learning Training Course for Italian Physicians. Front Genet 2021; 12:626685. [PMID: 33790945 PMCID: PMC8005606 DOI: 10.3389/fgene.2021.626685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The rapid spread of personalized medicine requires professionals to manage the "omics revolution." Therefore, the genetics/genomics literacy of healthcare professionals should be in line with the continuous advances in this field, in order to implement its potential implications for diagnosis, control and treatment of diseases. The present study investigates the effectiveness of a distance learning course on genetics and genomics targeted at medical doctors. METHODS In the context of a project funded by the Italian Ministry of Health, we developed a distance learning course, entitled Genetics and Genomics practice. The course focused on genetic/genomics testing, pharmacogenetics and oncogenomics and was developed according to andragogical training methods (Problem-based Learning and Case-based Learning). We used a pre-test vs. post-test study design to assess knowledge improvement on a set of 10 Multiple Choice Questions (MCQs). We analyzed the proportion of correct answers for each question pre and post-test and the mean score difference stratified by gender, age, professional status and medical discipline. Moreover, the test was submitted to the participants 8 months after the conclusion of the course (follow-up), in order to assess the retained knowledge. RESULTS The course was completed by 1,637 Italian physicians, most of which were primary care physicians (20.8%), public health professionals (11.5%) and specialist pediatricians (10.6%). The proportion of correct answers increased in the post-test for all the MCQs. The overall mean score significantly increased, from 59.46 in the pre-test to 71.42 in the post-test (p < 0.0001). The comparison in test performance between follow-up and pre-test demonstrated an overall knowledge improvement. CONCLUSION Genomics literacy among healthcare professionals is essential to ensure optimal translation to healthcare delivery of research. The results of this course suggest that distance-learning training in genetic/genomics practice represents an effective method to improve physicians' knowledge in the immediate and mid-term time scale. A preprint version of this paper is available at: https://www.researchsquare.com/article/rs-10083/v1.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessia Tognetto
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alfonso Mazzaccara
- Servizio Formazione – Presidenza, Istituto Superiore di Sanità, Rome, Italy
| | - Donatella Barbina
- Servizio Formazione – Presidenza, Istituto Superiore di Sanità, Rome, Italy
| | - Pietro Carbone
- Servizio Formazione – Presidenza, Istituto Superiore di Sanità, Rome, Italy
| | - Debora Guerrera
- Servizio Formazione – Presidenza, Istituto Superiore di Sanità, Rome, Italy
| | | | - Antonio Federici
- Direzione Generale Prevenzione Sanitaria, Ministero della Salute, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health – Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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31
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Traversi D, Pulliero A, Izzotti A, Franchitti E, Iacoviello L, Gianfagna F, Gialluisi A, Izzi B, Agodi A, Barchitta M, Calabrò GE, Hoxhaj I, Sassano M, Sbrogiò LG, Del Sole A, Marchiori F, Pitini E, Migliara G, Marzuillo C, De Vito C, Tamburro M, Sammarco ML, Ripabelli G, Villari P, Boccia S. Precision Medicine and Public Health: New Challenges for Effective and Sustainable Health. J Pers Med 2021; 11:135. [PMID: 33669364 PMCID: PMC7920275 DOI: 10.3390/jpm11020135] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 02/06/2023] Open
Abstract
The development of high-throughput omics technologies represents an unmissable opportunity for evidence-based prevention of adverse effects on human health. However, the applicability and access to multi-omics tests are limited. In Italy, this is due to the rapid increase of knowledge and the high levels of skill and economic investment initially necessary. The fields of human genetics and public health have highlighted the relevance of an implementation strategy at a national level in Italy, including integration in sanitary regulations and governance instruments. In this review, the emerging field of public health genomics is discussed, including the polygenic scores approach, epigenetic modulation, nutrigenomics, and microbiomes implications. Moreover, the Italian state of implementation is presented. The omics sciences have important implications for the prevention of both communicable and noncommunicable diseases, especially because they can be used to assess the health status during the whole course of life. An effective population health gain is possible if omics tools are implemented for each person after a preliminary assessment of effectiveness in the medium to long term.
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Affiliation(s)
- Deborah Traversi
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, 10126 Torino, Italy;
| | - Alessandra Pulliero
- Department of Health Sciences School of Medicine, University of Genoa, 16132 Genova, Italy;
| | - Alberto Izzotti
- Department of Experimental Medicine, University of Genoa, 16132 Genova, Italy;
- IRCCS Ospedale Policlinico San Martino, 161632 Genova, Italy
| | - Elena Franchitti
- Department of Public Health and Pediatrics, University of Torino, Piazza Polonia 94, 10126 Torino, Italy;
| | - Licia Iacoviello
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; (L.I.); (F.G.)
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (B.I.)
| | - Francesco Gianfagna
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; (L.I.); (F.G.)
- Mediterranea Cardiocentro, 80122 Napoli, Italy
| | - Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (B.I.)
| | - Benedetta Izzi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (B.I.)
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.A.); (M.B.)
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.A.); (M.B.)
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.E.C.); (I.H.); (M.S.); (S.B.)
| | - Ilda Hoxhaj
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.E.C.); (I.H.); (M.S.); (S.B.)
| | - Michele Sassano
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.E.C.); (I.H.); (M.S.); (S.B.)
| | - Luca Gino Sbrogiò
- Dipartimento di Prevenzione, Az. ULSS3 Serenissima, 30174 Venezia, Italy;
| | | | | | - Erica Pitini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy; (E.P.); (G.M.); (C.M.); (C.D.V.); (P.V.)
| | - Giuseppe Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy; (E.P.); (G.M.); (C.M.); (C.D.V.); (P.V.)
| | - Carolina Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy; (E.P.); (G.M.); (C.M.); (C.D.V.); (P.V.)
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy; (E.P.); (G.M.); (C.M.); (C.D.V.); (P.V.)
| | - Manuela Tamburro
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy; (M.T.); (M.L.S.); (G.R.)
| | - Michela Lucia Sammarco
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy; (M.T.); (M.L.S.); (G.R.)
| | - Giancarlo Ripabelli
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy; (M.T.); (M.L.S.); (G.R.)
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy; (E.P.); (G.M.); (C.M.); (C.D.V.); (P.V.)
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.E.C.); (I.H.); (M.S.); (S.B.)
- Department of Woman and Child Health and Public Health-Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
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Acampora A, Grossi A, Barbara A, Colamesta V, Causio FA, Calabrò GE, Boccia S, de Waure C. Increasing HPV Vaccination Uptake among Adolescents: A Systematic Review. Int J Environ Res Public Health 2020; 17:E7997. [PMID: 33143171 PMCID: PMC7663345 DOI: 10.3390/ijerph17217997] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/02/2020] [Accepted: 10/27/2020] [Indexed: 12/28/2022]
Abstract
Human Papillomavirus (HPV) vaccination is a well-known fundamental strategy in the prevention of cervical cancer, as it is always caused by HPV infection. In fact, primary prevention of the infection corresponds to primary prevention of HPV-related cancers and other diseases. Since an effective prevention at the population level is the final goal, it is mandatory for healthcare systems to achieve a high HPV vaccination coverage among the adolescents to reduce the circulation of the virus and the burden of HPV-related diseases. This research identified, through a systematic literature review, 38 papers on strategies adopted to increase HPV vaccination coverage among adolescents. The evaluated strategies targeted adolescents/parents and/or healthcare providers and could be grouped in three main types: (1) reminder-based, (2) education, information, and communication activities, and (3) multicomponent strategies. Several types of strategy, such as those relied only on reminders and integrating different interventions, showed a positive impact on vaccination coverage. Nonetheless, the heterogeneity of the interventions suggests the importance to adapt such strategies to the specific national/local contexts to maximize vaccination coverage.
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Affiliation(s)
- Anna Acampora
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.A.); (A.G.); (A.B.); (V.C.); (F.A.C.); (S.B.)
| | - Adriano Grossi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.A.); (A.G.); (A.B.); (V.C.); (F.A.C.); (S.B.)
| | - Andrea Barbara
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.A.); (A.G.); (A.B.); (V.C.); (F.A.C.); (S.B.)
| | - Vittoria Colamesta
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.A.); (A.G.); (A.B.); (V.C.); (F.A.C.); (S.B.)
- Unità Operativa Complessa Direzione Sanitaria S. Spirito e Nuovo Regina Margherita, Local Health Unit ASL RM1, 00193 Rome, Italy
| | - Francesco Andrea Causio
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.A.); (A.G.); (A.B.); (V.C.); (F.A.C.); (S.B.)
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.A.); (A.G.); (A.B.); (V.C.); (F.A.C.); (S.B.)
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.A.); (A.G.); (A.B.); (V.C.); (F.A.C.); (S.B.)
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
| | - Chiara de Waure
- Department of Experimental Medicine, University of Perugia, 06132 Perugia, Italy;
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Calabrò GE, Sassano M, Tognetto A, Boccia S. Citizens' Attitudes, Knowledge, and Educational Needs in the Field of Omics Sciences: A Systematic Literature Review. Front Genet 2020; 11:570649. [PMID: 33193671 PMCID: PMC7644959 DOI: 10.3389/fgene.2020.570649] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/22/2020] [Indexed: 01/07/2023] Open
Abstract
Background: The huge development of omics sciences is changing the classical medical approach and making new technologies available. In this context, education of citizens is essential to allow appropriate decisions about their own health. Hence, we aimed to summarize existing literature regarding citizens' knowledge, attitudes, and educational needs on omics sciences. Methods: We performed a systematic literature review (SLR) using Pubmed, ISI Web of Science, and Embase databases. The eligibility criteria for inclusion in this review required that the studies investigated knowledge, attitudes, or educational needs regarding omics sciences among the general population. Results: We included 54 studies, published between 2006 and 2020. Most of the included studies (72%) investigated citizens' knowledge, half of them (56%) attitudes, and 20% educational needs in the field of omics sciences, while 52% investigated attitudes and perceptions about genetic and/or omics tests. Most studies (64%) reported a limited knowledge level among citizens, even though most (59%) reported participants understood the benefits of the use of omics sciences into medicine. As for omics tests, a controversial opinion toward their use into practice was reported among citizens. Most of the studies (82%) investigating citizens' educational needs highlighted a clear gap to be filled. Conclusions: Our SLR summarizes current knowledge on citizens' literacy, attitudes, and educational needs on omics science, underlining the need for strengthening public engagement on this topic. Further research is needed, however, to identify appropriate methods and models to achieve such an improvement.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michele Sassano
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessia Tognetto
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Woman and Child Health and Public Health-Public Health Area, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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Sassano M, Calabrò GE, Tognetto A, Federici A, Ricciardi W, Boccia S. Systematic review on citizens’ literacy in omic sciences and web search of initiatives to improve it. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
We are assisting to a progressive change in the classical approach to patient care toward so-called personalized medicine, mainly driven by the development of omic sciences. To implement omic sciences into practice it is important to address healthcare professionals', policy makers', leaders', and citizens' literacy
Methods
As part of a project funded by the Italian Centre for Disease Prevention and Control (CCM), we carried out a systematic review (SR) on citizens' attitude, knowledge, and educational needs in omic sciences. The search was carried out on Pubmed, Web of Science, and Embase. We also conducted a separate web search on Google, Yahoo, and Bing on initiatives published in Italian and English aimed at improving citizens' literacy in the same field. Websites of retrieved initiatives were examined to identify additional resources
Results
Forty-nine studies were included in the SR. Most studies (n = 26, 66.7%) reported low levels of knowledge in omic sciences among citizens, and conflicting attitudes related to potential risks and benefits of omic sciences. Eleven studies (22%) evaluated citizens' educational needs, and most (n = 9, 82%) reported a clear knowledge gap. As for the web search, 13 initiatives were identified in Italy, 4 in Europe, and 22 in non-European Countries. Overall, 33% of them required in-person attendance, while 67% were web-based resources. The former included exhibitions, seminars, courses, symposia, information stands in public places, guided visits at research laboratories, and interactive laboratories; the latter included web-pages for reading, online lessons and courses, web portals for information, videos and short movies, animations, apps for mobile devices
Conclusions
Results show a clear need to improve citizens' literacy. To achieve this goal, the implementation of effective strategies and initiatives is crucial, hence this effort to summarize the existing ones will be essential for future plan developments.
Key messages
The current challenge is to identify effective methods of improving citizens' literacy and implementing them. Only through citizens’ empowerment the implementation of omic sciences in the Health System will be possible, since citizens are increasingly active in the health context.
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Affiliation(s)
- M Sassano
- Section of Hygiene, Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - G E Calabrò
- Section of Hygiene, Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - A Tognetto
- Section of Hygiene, Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | | | - W Ricciardi
- Section of Hygiene, Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
- Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S Boccia
- Section of Hygiene, Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
- Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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35
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Calabrò GE, Mazzaccara A, Carbone P, Barbina D, Guerrera D, Di Pucchio A, Sassano M, Federici A, Ricciardi W, Boccia S. Distance learning training in genetics and genomics practices for Italian healthcare professionals. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Genomics and related fields are becoming increasingly relevant in healthcare practice. Italy is the first European country with a structured policy of Public Health Genomics and dedicated guidelines that focus on three pillars: Health Technology Assessment of omic applications, promotion of citizens' literacy, and promotion of extensive training for all healthcare stakeholders. In January 2019 we initiated a project funded by the Italian Ministry of Health and entitled 'Capacity building and Citizens-Omics'.
Objectives
The project is coordinated by the National Institute of Health and is aimed at implementing the “Italian National Plan for innovation of the healthcare system based on omics sciences” published in 2017.
Results
The project had set-up two distance-learning courses on genetic/genomics: an advanced course for physicians and biologists, and a basic one for the remaining healthcare professionals. The courses focused on genetic/genomic testing in clinical practice, pharmacogenomics and oncogenomic and they were developed according to the main models of andragogical training (Problem-based Learning and Case-based Learning). The courses include audio-video lectures and interactive clinical cases and they will be accessible free of charge for a year (from February 17th 2020). In three weeks, we had 2129 participants (1101 physicians, 1028 biologists) for the advanced course and 10.000 for the basic one.
Conclusions
Genomic literacy among healthcare professionals is essential to ensure optimal translation to healthcare delivery of research. The distance-learning training in genetic/genomic practices represents an effective method to improve healthcare professionals' knowledge in the immediate and mid-term time scale. Our courses represent the third Italian experience in distance training in omic field. The educational effects related with online courses could potentially be relevant internationally and across a wider range of potential audiences.
Key messages
In view of the ongoing rapid developments in genetics research it is important that omic literacy among healthcare providers be enhanced to ensure translation to healthcare delivery of research. E-learning training appears to offer a cost-effective and time-efficient method of improving omic knowledge and it could be relevant across a wider range of potential audiences.
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Affiliation(s)
- G E Calabrò
- Sezione di Igiene, Dipartimento di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - P Carbone
- National Institute of Health, Rome, Italy
| | - D Barbina
- National Institute of Health, Rome, Italy
| | - D Guerrera
- National Institute of Health, Rome, Italy
| | | | - M Sassano
- Sezione di Igiene, Dipartimento di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - W Ricciardi
- Sezione di Igiene, Dipartimento di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S Boccia
- Sezione di Igiene, Dipartimento di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Carini E, Calabrò GE, Tognetto A, Mancinelli S, Sarnari L, Colamesta V, Ricciardi W, de Waure C. BRaVE Project: processing an evidence-based tool to develop and evaluate vaccination strategies. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Deaths and epidemics due to vaccine-preventable diseases still occur even though there are effective vaccines available. Albeit recommendations released by the Italian Ministry of Health, vaccination coverages remain unsatisfactory. An improvement is therefore needed and new strategies are deserved in order to increase coverage. Nevertheless, neither a validated tool nor an institutional guideline to plan and/or evaluate vaccination strategies are available. The aim of BRaVE project was to build an evidence-based tool to develop and assess them.
Methods
In May 2019, a scoping review in MEDLINE and a search of ECDC and WHO websites were performed to look for validated tools to plan and/or evaluate vaccination strategies. The results of the search and the four phases of the Deming cycle (Plan, Do, Check, Act) were used to develop a grid. A multiprofessional panel of 7 experts validated the items included in the grid through a Delphi process followed by a face-to-face meeting.
Results
The original grid submitted to the panel of experts included 30 items (13 planning, 7 implementation, 4 check, 4 act, 2 other). The first round of Delphi led to the suggestion of 11 additional items and to the amendment of 4 out of 30 original items. During the second round of the Delphi the 41 items proposed were approved. At the end of the face-to-face meeting, 1 item was split. Seven items belonging to “Planning” (Plan) and “Implementation” (Do) were labelled as requisites for launching a vaccination strategy and the remaining 35 as items to be considered in their evaluation (15 planning, 11 implementation, 8 check, 4 act, 4 other).
Conclusions
Despite its importance, vaccination coverage is low. Evidence shows possible improvement in coverage, if innovative vaccination strategies are put in place. The developed grid is proposed as an organizational instrument which could improve and standardize vaccination strategies fostering their success and transferability.
Key messages
Novel organizational strategies could be a useful answer to improve vaccination coverage. The proposed grid could be used for the development and assessment of vaccination strategies.
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Affiliation(s)
- E Carini
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - G E Calabrò
- Università Cattolica del Sacro Cuore, Rome, Italy
- VIHTALI, Spin - Off Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Tognetto
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Mancinelli
- Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - L Sarnari
- Corso di formazione specifica in Medicina Generale, Regione Marche, Ancona, Italy
| | - V Colamesta
- Università Cattolica del Sacro Cuore, Rome, Italy
- UOC Direzione Sanitaria S. Spirito e Nuovo Regina Margherita, ASL RM1, Rome, Italy
| | - W Ricciardi
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C de Waure
- Dipartimento di Medicina Sperimentale, Università degli Studi di Perugia, Perugia, Italy
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Calabrò GE, Tognetto A, Carini E, Mancinelli S, Sarnari L, Colamesta V, Ricciardi W, de Waure C. Strategies to Improve Vaccination among At-Risk Adults and the Elderly in Italy. Vaccines (Basel) 2020; 8:vaccines8030358. [PMID: 32635467 PMCID: PMC7565655 DOI: 10.3390/vaccines8030358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/14/2022] Open
Abstract
The World Health Organization (WHO), the United States (US) Centers for Disease Control and Prevention (CDC), the European Center for Disease Control (ECDC), and the immunization guidelines of many countries issue vaccination recommendations for adults and the elderly. However, the uptake of vaccination in these groups is generally low due to several reasons. The present study aimed to identify strategies implemented in Italy in unconventional settings to promote vaccination against influenza, pneumococcal, and herpes zoster virus (HZV) infections among these subjects, i.e., the at-risk adult population and the elderly. We conducted a literature review and a survey of experts. The literature search yielded seven strategies; all of these concerned influenza vaccination, while three also addressed pneumococcal and HZV vaccination. The survey of experts identified 15 strategies; 10 regarded influenza vaccination, while four regarded pneumococcal vaccination and one regarded HZV vaccination. Most of the strategies were implemented in hospital clinics and rest homes. Regarding influenza and pneumococcal vaccinations, the target population mainly comprised at-risk adults, while the elderly represented the main target population for HZV vaccination. Our results show that, in Italy, there are initiatives aimed at promoting vaccination in unconventional settings, but further efforts are required to assess their effectiveness and to further extend them.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alessia Tognetto
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
| | - Elettra Carini
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
| | - Silvia Mancinelli
- Department of Pneumological Sciences, Section of Pneumology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Laura Sarnari
- Regional Health Unit ASUR AV 3, Sanitary District of Macerata, 62100 Macerata, Italy;
| | - Vittoria Colamesta
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
- UOC Direzione Sanitaria S. Spirito e Nuovo Regina Margherita, Local Health Unit ASL RM1, 00193 Rome, Italy
- Correspondence:
| | - Walter Ricciardi
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Chiara de Waure
- Department of Experimental Medicine, University of Perugia, 06132 Perugia, Italy;
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Acampora A, Grossi A, Barbara A, Colamesta V, Causio FA, Calabrò GE, Boccia S, De Waure C. Increasing HPV vaccination uptake among adolescents: A Systematic Review. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Human Papillomavirus (HPV) is responsible for the development of several pathologies besides the cervical cancer and HPV vaccination is a key strategy for primary prevention. The aim of this research was to identify strategies adopted to increase HPV vaccination coverage among the adolescents.
Methods
A systematic review was carried-out by searching electronic databases (Pubmed, Scopus, and Web of Science) using selected keywords as “papillomavirus vaccine”, “vaccination strategy” and “efficacy”. Articles conducted in high-income countries and evaluating the impact of one or more strategies on vaccination coverage (initiation e/o completion) in adolescents were included.
Results
Out of 3571 single citations screened, 42 papers (2011-2018) were included. Study size ranged from 50 to 325229 individuals. The major part of the studies was from the United States (n = 35; 83,3%) and conducted with an experimental design (n = 17; 40,5%). The evaluated outcomes included first dose uptake, schedule completion, vaccination timeliness and the number of administered doses. Identified strategies included reminds (9), education activities (9), multicomponent strategies (22) and others (2) and were focused on adolescents/parents and/or healthcare providers. Significant positive results were reported in seven studies (77,8%) evaluating the impact of reminds, four studies (44,4%) on education strategies, and in 12 studies (54,5%) on multicomponent strategies. Offering vaccination in “bundle” or during any medical visit was also reported as significantly effective.
Conclusions
Increasing the vaccination coverage is essential to achieve HPV-related diseases control. Several types of strategies are available and showed a positive impact on vaccination uptake, in particular those relied on reminds. Nonetheless, the heterogeneity of interventions suggests the importance to adapt such initiatives to the specific context in order to maximize the improvement in vaccination uptake.
Key messages
Several types of strategies to increase vaccination uptake are available at international level and showed a positive impact among adolescents. These interventions are heterogeneous suggesting the importance of their adaptation to the specific context in order to gain the maximum improvement in vaccination uptake.
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Affiliation(s)
- A Acampora
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - A Grossi
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - A Barbara
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - V Colamesta
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
- UOC Direzione Sanitaria S. Spirito e Nuovo Regina Margherita, Local Health Unit ASL RM1, Rome, Italy
| | - F A Causio
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - G E Calabrò
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - S Boccia
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - C De Waure
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
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Acampora A, Grossi A, Colamesta V, Barbara A, Causio A, Calabrò GE, Boccia S, Cicchetti A, de Waure C. Strategies to achieve HPV-related disease control in Italy: results from an integrative approach. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Vaccination against Human Papilloma Virus (HPV) might allow controlling HPV-related diseases but coverage in Italy is far from the optimal goal. This project aimed at identifying strategies to promote HPV vaccination in Italy.
Methods
an integrative approach including a systematic review and a two-step panel consultation was used to identify strategies for improving coverage among adolescents who are already target of the national campaign and promote vaccination in further targets. The systematic review followed PRISMA recommendations and the panel consultation relied on the administration of questionnaires in the first step and on a televoting system during a consensus conference in the second one. Ten experts were involved belonging to Gynecology, Public Health, General Practice, Pediatrics and Consumers. Recommendations relied on a set of criteria drawn from the Evidence to Decision framework.
Results
The systematic review led the identification of three main strategies to improve coverage respectively based on reminds, education and multicomponent approaches. Following the evaluation of selected criteria, namely relevance of benefits, evidence strength, feasibility, equity, acceptability and costs, a strong recommendation was formulated on the use of reminds tailored to vaccine recipients or their parents whereas a moderate one was developed on the use of reminds directed to health professionals. A moderate recommendation was released on the implementation of multicomponent interventions. The panel consultation also supported the elaboration of a strong recommendation on the promotion of vaccination among women treated for HPV-related diseases, fertile women not yet vaccinated and 25 years old women. Catch-up initiatives, in particular among women and men 18 years old, were also identified as strongly recommendable.
Conclusions
This project led to identify several valuable strategies to strengthen HPV vaccination at national level.
Key messages
Using reminds tailored to vaccine recipients or their parents is strongly recommended while using reminds directed to health professionals and multicomponent interventions are moderately recommended. It is strongly recommended to promote HPV vaccination among women treated for HPV-related diseases, fertile women not yet vaccinated and 25 years old women.
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Affiliation(s)
- A Acampora
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - A Grossi
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - V Colamesta
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - A Barbara
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - A Causio
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - G E Calabrò
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - S Boccia
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - A Cicchetti
- School of Health Economics and Management, Catholic University of Sacred Heart, Rome, Italy
| | - C de Waure
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
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Specchia ML, La Torre G, Calabrò GE, Villari P, Grilli R, Federici A, Ricciardi W, de Waure C. Disinvestment in cancer care: a survey investigating European countries' opinions and views. Eur J Public Health 2019. [PMID: 29538676 DOI: 10.1093/eurpub/cky033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The current economic context calls for rationalizing health resources that can be pursued through disinvestment from low value health technologies to invest in the best performing ones, ensuring high healthcare quality. Oncology is a field where, because of high costs of health technologies and rapid innovation, disinvestment is crucial. Methods On this basis, the research team investigated through a survey, based on a questionnaire, opinions and views of representatives of European countries about disinvestment, in terms of fields of application, potential advocates and barriers, specifically focusing on cancer care. Results A total of 17 questionnaires were filled in (response rate: 32.1%). The survey showed disinvestment is applied in several countries as a tool for containing health care expenditures and identifying obsolete technologies/ineffective interventions. Clinicians' resistance to change and industries' opposition are recognized as the most important barriers to the implementation of disinvestment policies. Potential targets of disinvestment in cancer are seen in diagnostic and therapeutic areas. Conclusion Despite the agreement on fields of waste and of disinvestment policies, operational methods to put disinvestment in place are lacking. Since they should rely on an inclusive assessment of the technology, Health Technology Assessment may represent a good approach.
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Affiliation(s)
- Maria Lucia Specchia
- Section of Hygiene - Institute of Public Health, Università Cattolica del Sacro Cuore, IRCCS Fondazione Policlinico "Agostino Gemelli", Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene - Institute of Public Health, Università Cattolica del Sacro Cuore, IRCCS Fondazione Policlinico "Agostino Gemelli", Rome, Italy
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy
| | - Roberto Grilli
- Department of Clinical Governance, Local Health Authority of Reggio Emilia, Italy
| | - Antonio Federici
- General Directorate for Health Prevention, Ministry of Health, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene - Institute of Public Health, Università Cattolica del Sacro Cuore, IRCCS Fondazione Policlinico "Agostino Gemelli", Rome, Italy
| | - Chiara de Waure
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
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Calabrò GE, Tognetto A, Mazzaccara A, Barbina D, Carbone P, Guerrera D, Federici A, Ricciardi W, Boccia S. [Omic sciences and capacity building of health professionals: a distance learning training course for Italian physicians, 2017-2018]. Ig Sanita Pubbl 2019; 75:105-124. [PMID: 31377756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Nowadays, a strategy to manage the current "omic revolution" is needed in Italy. Actions aimed to improve genetic/omics "literacy" among health professionals and citizens are necessary, based on recommendations outlined in the Italian 2013 Guidelines on genomics in public health, and the 2018 National Plan for the innovation of the health system based on the omic sciences. MATERIALS AND METHODS In the context of a project funded by the Italian Ministry of Health, a distance-learning course entitled "Genetic and Genomic practices" was developed, targeted at medical professionals (mainly general practitioners). The main objective of the course was to train physicians in the responsible use of omic technologies. The course was structured according to the main models of adult learning theory (Problem-based-learning and case studies) and delivered on the institutional platform of the Italian National Institute of Health for one year, from February 2017 to February 2018, with the endorsement of the Italian Society of Hygiene and Preventive Medicine and the Italian Society of Human Genetics. RESULTS In one year, 3,054 participants registered for the course and 53% completed it. About 21% of participants were primary care physicians, 12% were public health physicians and 11% were hospital paediatricians. The most represented age group of participants was 51-65 years and their geographical distribution was 38.5% southern Italy/islands, 36.3% northern Italy and 25.2% central Italy. Pre-test data showed that training needs of primary care physicians was very high. CONCLUSIONS In the current context, characterized by the "omic revolution", physicians must be able to understand its potential implications for the diagnosis, control and treatment of diseases. It is therefore necessary to work on capacity building of all health professionals involved in various ways in the use of the "omic sciences". Distance-learning training in genetic/genomic practices represents a low-cost, satisfactory and clinically applicable method to improve physicians' knowledge.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Alessia Tognetto
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | | | | | | | | | | | - Walter Ricciardi
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italia
| | - Stefania Boccia
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italia
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Cacciatore P, Calabrò GE, Mogini V, Moraca E, Makishti O, Campanella P, Ricciardi W, Specchia ML. Lean thinking in the hospital setting - Results of a systematic review of literature. Ig Sanita Pubbl 2019; 75:29-50. [PMID: 31185489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM The aim of this study was to review experiences of use of the Lean methodology in the hospital setting and assess the impact of the interventions in terms of time of processes, productivity, effects on staff and patientd satisfaction. METHODS PubMed, Scopus and CINAHL databases were searched to identify studies evaluating the lean methodology. Two reviewers screened the citations identified and extracted data according to the PRISMA methodology. RESULTS In total, 635 citations were identified, of which 27 were included in the present review. Most studies showed a positive outcome related to the implementation of the Lean methodology and tools.
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Affiliation(s)
- Pasquale Cacciatore
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Giovanna Elisa Calabrò
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Valerio Mogini
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Eleonora Moraca
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Ornela Makishti
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Paolo Campanella
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
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Specchia ML, Marchiori S, Frisicale EM, Calabrò GE, Carini E, Pezzullo A, Ricciardi W, Damiani G. [Improving Hospital efficiency: assessment of performance of a surgical suite through root cause analysis, in a hospital in northern Italy]. Ig Sanita Pubbl 2019; 75:11-28. [PMID: 31185488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A Surgical Suite (SS) is a complex system in which different healthcare professionals work. Inefficient management could lead to waste of money and time and reduce quality of care. The aim of the study was to carry out an organizational assessment of a SS in northern Italy, in order to identify weaknesses and inadequacies related to its performance and promote strategies to increase efficiency. The study was conducted by process mapping of the working context, qualitative and quantitative analysis of patient documents and an evaluation of the critical issues using the root cause analysis (RCA) tool. The Plan Do Check Act (PDCA) method was used to implement the necessary changes. A detailed description of the staff involved, medical devices available, organization and timing of the SS was performed. Inefficiencies in the unit were caused mainly by insufficient medical devices and underusage of the radiological software Picture Archiving and Communication System (PACS). Root causes of inefficiencies were identified and classified into four areas: organization/structure, personnel, technologies and methods. In particular, critical issues were identified in: the planning processes, the heterogeneity of technical and Information technology skills and educational background of nursing staff, the presence of several computerized information systems and lack of a connection interface between the different software, the lack of internal procedures and paths and lack of continuing professional education opportunities. Two multidisciplinary working tables were launched by the hospital management in order to identify improvement strategies. The evaluation allowed us to define the root causes of SS inefficiency in this hospital, leading to a reorganization with a view to continuous improvement. An innovative aspect of the present study was the use of RCA to perform an organizational assessment in healthcare, rather than as a reactive risk management tool.
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Affiliation(s)
| | | | - Emanuela Maria Frisicale
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Giovanna Elisa Calabrò
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Elettra Carini
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Angelo Pezzullo
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
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Calabrò GE, La Torre G, de Waure C, Villari P, Federici A, Ricciardi W, Specchia ML. Disinvestment in healthcare: an overview of HTA agencies and organizations activities at European level. BMC Health Serv Res 2018; 18:148. [PMID: 29490647 PMCID: PMC5831213 DOI: 10.1186/s12913-018-2941-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background In an era of a growing economic pressure for all health systems, the interest for “disinvestment” in healthcare increased. In this context, evidence based approaches such as Health Technology Assessment (HTA) are needed both to invest and to disinvest in health technologies. In order to investigate the extent of application of HTA in this field, methodological projects/frameworks, case studies, dissemination initiatives on disinvestment released by HTA agencies and organizations located in Europe were searched. Methods In July 2015, the websites of HTA agencies and organizations belonging to the European network for HTA (EUnetHTA) and the International Network of Agencies for HTA (INAHTA) were accessed and searched through the use of the term “disinvestment”. Retrieved deliverables were considered eligible if they reported methodological projects/frameworks, case studies and dissemination initiatives focused on disinvestment in healthcare. Results 62 HTA agencies/organizations were accessed and eight methodological projects/frameworks, one case study and one dissemination initiative were found starting from 2007. With respect to methodological projects/frameworks, two were delivered in Austria, one in Italy, two in Spain and three in U.K. As for the case study and the dissemination initiative, both came from U.K. The majority of deliverables were aimed at making an overview of existing disinvestment approaches and at identifying challenges in their introduction. Conclusions Today, in a healthcare context characterized by resource scarcity and increasing service demand, “disinvestment” from low-value services and reinvestment in high-value ones is a key strategy that may be supported by HTA. The lack of evaluation of technologies in use, in particular at the end of their lifecycle, may be due to the scant availability of frameworks and guidelines for identification and assessment of obsolete technologies that was shown by our work. Although several projects were carried out in different countries, most remain constrained to the field of research. Disinvestment is a relatively new concept in HTA that could pose challenges also from a methodological point of view. To tackle these challenges, it is necessary to construct experiences at international level with the aim to develop new methodological approaches to produce and grow evidence on disinvestment policies and practices. Electronic supplementary material The online version of this article (10.1186/s12913-018-2941-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G E Calabrò
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, L.go F. Vito 1, 00168, Rome, Roma, Italy
| | - G La Torre
- Department of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy
| | - C de Waure
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, L.go F. Vito 1, 00168, Rome, Roma, Italy. .,Department of Experimental Medicine, University of Perugia, via Gambuli 1, 06132, Perugia, Italy.
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy
| | | | - W Ricciardi
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, L.go F. Vito 1, 00168, Rome, Roma, Italy
| | - M L Specchia
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, L.go F. Vito 1, 00168, Rome, Roma, Italy
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Di Nardo F, Calabrò GE, Ianuale C, Poscia A, Azzolini E, Volpe M, de Waure C. Capturing the chance for pneumococcal vaccination in the hospital setting. Ann Ist Super Sanita 2018; 53:291-298. [PMID: 29297858 DOI: 10.4415/ann_17_04_04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Because of the relevant burden of pneumococcal diseases, newborns, people at risk and elderly are recommended vaccination but coverage is still low for problems in catching them. This study evaluates the proportion of eligible patients seen at hospital level in the view of assessing its potential role in vaccination campaigns. METHODS This is a retrospective analysis of discharge data of all patients over 49 years of age admitted between 2011 and 2013 to "A. Gemelli" teaching hospital. Eligibility for pneumococcal vaccination was evaluated based on ICD-9 codes. RESULTS Among 65 047 unique patients, 53.2% were eligible for pneumococcal vaccination. Most common eligibility criteria were chronic heart diseases, cancer and diabetes. Considering also age ≥ 65 as an indication to vaccination, the proportion of eligible patients reached 76.8%. The highest number of eligible patients was seen in medical sciences, general surgery, cardiovascular medicine and neurosciences departments. CONCLUSIONS Hospital might play an important role in catching patients eligible for pneumococcal vaccination because their proportion in the hospital setting is high.
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Affiliation(s)
- Francesco Di Nardo
- Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore di Roma, Rome, Italy
| | | | - Carolina Ianuale
- Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore di Roma, Rome, Italy
| | - Andrea Poscia
- Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore di Roma, Rome, Italy
| | - Elena Azzolini
- Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore di Roma, Rome, Italy
| | - Massimo Volpe
- Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Chiara de Waure
- Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore di Roma, Rome, Italy
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D'Andrea M, Nedovic D, Calabrò GE, Delon M, Ricciardi W, de Waure C. The impact of telemedicine in reducing onset to treatment time in the management of acute stroke. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M D'Andrea
- Institute of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - D Nedovic
- Faculty of Medicine, University of Nis, Nis, Serbia
| | - GE Calabrò
- Institute of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - M Delon
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - C de Waure
- Institute of Public Health, Catholic University of the Sacred Heart, Rome, Italy
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Calabrò GE, Mazzaccara A, Barbina D, Carbone P, Guerrera D, Federici A, Ricciardi W, Boccia S. Distance learning training in genetics and genomics practices for Italian physicians. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- GE Calabrò
- Department of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
| | - A Mazzaccara
- Department of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
| | - D Barbina
- National Institute of Health, Rome, Italy
| | - P Carbone
- National Institute of Health, Rome, Italy
| | - D Guerrera
- National Institute of Health, Rome, Italy
| | | | - W Ricciardi
- President of the National Institute of Health, Rome, Italy
| | - S Boccia
- Department of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
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Arzani D, Lagerberg T, Calabrò GE, Michelazzo MB, Boccia S. Effectiveness of educational interventions to improve genomic competency in medical doctors. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Arzani
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - GE Calabrò
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - MB Michelazzo
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Boccia
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Specchia ML, Cacciatore P, Rossini G, Calabrò GE, Ferriero AM, Petitti T, Rosolia A, Ricciardi W, Damiani G. Do Public-Private Partnerships add value to healthcare delivery? Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- ML Specchia
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Cacciatore
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Rossini
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - GE Calabrò
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - AM Ferriero
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - T Petitti
- Public Health Research and Statistics Unit, Università Campus Bio-Medico, Rome, Italy
| | - A Rosolia
- Public Health Research and Statistics Unit, Università Campus Bio-Medico, Rome, Italy
| | - W Ricciardi
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Damiani
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Di Nardo F, Boccalini S, Calabrò GE, Marcellusi A, Ruggeri M, Bonanni P, Vitali R, Capannini E, Mennini FS, Cicchetti A, Panatto D, Gasparini R, Ricciardi W, De Waure C. [The economic value of vaccinations: a systematic review of Italian economic evaluations and HTA reports]. Ig Sanita Pubbl 2017; 73:453-471. [PMID: 29433132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Decision-making in healthcare should rely on evidence-based approaches able to make possible a transparent and robust assessment of all the aspects related to health technologies. One of the assessment elements is represented by the efficiency that is the specific objective of economic evaluations and also of Health Technology Assessment (HTA). The collection and synthesis of evidence is the first indispensable step in order to foster a proper convey of scientific knowledge to the decision-makers. This work, carried out within a broader project on the transfer of evidence from the scientific to the decision making world, is aimed to release an overview of economic evaluations and HTA on vaccines conducted in Italy. The project was carried out within the activities of the ISPOR Italy-Rome Chapter. METHODS A systematic review of Italian economic evaluations and HTA performed on vaccines and published up to May 2015 was carried out. PubMed, Scopus and the NIHR HTA databases were queried and a hand-search was performed on key journals in the field (Global & Regional Health Technology Assessment; PharmacoEconomics Italian Research Articles; Giornale italiano di HTA; Politiche Sanitarie; HTA Focus - Pills of Clinical Governance; Pillole di Farmacoeconomia; Giornale Italiano di Farmacoeconomia e Farmacoutilizzazione; IJPH; Quaderni dell'IJPH). Studies were considered eligible if showing the results of a full economic evaluations and if performed in Italy. RESULTS The literature search yielded 10 HTA reports and 33 economic evaluations. Among the latter, 20 (60,6%) were cost-effectiveness analyses. Ten studies (23,3%) assessed the vaccination against S. pneumoniae figuring out that it is cost-effectiveness and even costsaving in cases of newborns and subjects at risk. Nine studies (20,9%) addressed influenza vaccination and demonstrated its dominance on non-vaccination in the elderly. Eight studies (18,6%) evaluated the HPV vaccines concluding that they are cost-effective. Five studies (11,6%) devoted to anti-rotavirus vaccination showing its dominance on non-vaccination, in particular from the society perspective. Vaccination against pertussis, hepatitis B, chicken pox, measles, rubella, mumps were eventually shown cost-saving. The vaccine against Neisseria meningitidis was considered potentially cost-effective. CONCLUSION The Italian scientific evidence on efficiency of vaccination is broad and allows concluding that vaccinations are value for money interventions.
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Affiliation(s)
- Francesco Di Nardo
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Sara Boccalini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Italia
| | - Giovanna Elisa Calabrò
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Andrea Marcellusi
- Facoltà di Economia, Economic Evaluation and HTA (EEHTA) - CEIS, Università degli Studi di Roma Tor Vergata, Italia
| | - Matteo Ruggeri
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma, Italia
| | - Paolo Bonanni
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Italia
| | - Raffaella Vitali
- Facoltà di Economia, Economic Evaluation and HTA (EEHTA) - CEIS, Università degli Studi di Roma Tor Vergata, Italia
| | - Eleonora Capannini
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma, Italia
| | - Francesco Saverio Mennini
- Facoltà di Economia, Economic Evaluation and HTA (EEHTA) - CEIS, Università degli Studi di Roma Tor Vergata, Italia
| | - Americo Cicchetti
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma, Italia
| | - Donatella Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Italia
| | - Roberto Gasparini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Italia
| | - Walter Ricciardi
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Chiara De Waure
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia
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