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Marinello D, Palla I, Lorenzoni V, Andreozzi G, Pirri S, Ticciati S, Cannizzo S, Del Bianco A, Ferretti E, Santoni S, Turchetti G, Mosca M, Talarico R. Exploring disease perception in Behçet's syndrome: combining a quantitative and a qualitative study based on a narrative medicine approach. Orphanet J Rare Dis 2023; 18:58. [PMID: 36934245 PMCID: PMC10024433 DOI: 10.1186/s13023-023-02668-8] [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: 06/14/2022] [Accepted: 03/11/2023] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND Behçet Syndrome (BS) has a significant psychological and social impact on patients, caregivers and families. The present study aims at exploring disease perception in BS patients, using both a co-designed survey and the narrative medicine (NM) approach. METHODS An ad-hoc questionnaire was co-designed by clinicians expert in BS, BS patients and caregivers and BS adult patients were invited to answer the online questionnaires. Cluster analysis was used to analyse data from the survey and to identify groups of patients with diverse disease perception. To further explore real-life perspectives, the stories of illness of a smaller group of adult BS patients were anonymously collected online and analysed by means of text, sentiment and qualitative analysis. RESULTS Two hundred and seven patients answered the survey and forty-three stories were collected. The cluster analysis highlighted that accepting or not the disease has a strong impact on the daily life, on how BS patients perceive themselves and in terms of hope for the future. The stories revealed that patients often address common issues, such as the long and complex journey faced from the disease onset until the BS diagnosis, which was strongly connected to the concept of time and perceived as an exhausting period of their lives. CONCLUSION To our knowledge, this is the first study that addressed disease perception also applying the NM principles in BS. The current perception that BS patients have of their disease should encourage the BS scientific and patient community in joining forces in order to improve the journey of BS patients.
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Affiliation(s)
- D Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
| | - I Palla
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - V Lorenzoni
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - G Andreozzi
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S Pirri
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S Ticciati
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
| | - S Cannizzo
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - A Del Bianco
- Associazione S.I.M.B.A (Associazione Italiana Sindrome e Malattia di Behçet), Pontedera, Italy
| | - E Ferretti
- Associazione S.I.M.B.A (Associazione Italiana Sindrome e Malattia di Behçet), Pontedera, Italy
| | - S Santoni
- Associazione S.I.M.B.A (Associazione Italiana Sindrome e Malattia di Behçet), Pontedera, Italy
| | - G Turchetti
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - M Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy
- Rheumatology Unit, University of Pisa, Pisa, Italy
| | - R Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy.
- Rheumatology Unit, University of Pisa, Pisa, Italy.
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Pirri S, Talarico R, Marinello D, Turchetti G, Mosca M. A systematic literature review of existing tools used to assess medication adherence in connective tissue diseases: the state of the art for the future development of co-designed measurement tools. Reumatismo 2021; 73. [PMID: 34814655 DOI: 10.4081/reumatismo.2021.1418] [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: 03/31/2021] [Accepted: 09/18/2021] [Indexed: 11/23/2022] Open
Abstract
Lack of medication adherence is frequent in chronic connective tissue diseases and is associated with poorer health outcomes, low quality of life and economic loss. This research is based on a systematic literature search and aims to identify the surveys and tools used for the assessment of medication adherence in patients with connective tissue diseases (CTDs) and in particular the tools co-designed with patients. A systematic literature review was performed in PubMed and Embase databases searching for studies concerning the application of surveys or tools designed for medication adherence assessment. A specific analysis was also performed to identify which of these existing tools were developed in co-design with patients affected by CTDs. 1958 references were identified, and 31 studies were finally included. Systemic lupus erythematosus was the most investigated disease, followed by the Behçet's disease. The tools used to assess adherence in CTDs were, in most cases, valid and useful. However, the results showed a certain degree of heterogeneity among the studies and the medication adherence assessment and measurement tools adopted, which were mostly based on selfreported questionnaire. No co-designed tools with patients were found. Low- and non-adherence were explored in some CTDs with valid and useful tools, while other CTDs still need to be assessed. Therefore, more efforts should be made to better understand the specific reasons for the low- and non-adherence in CTDs patients.
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Affiliation(s)
- S Pirri
- Institute of Management, Scuola Superiore Sant'Anna, Pisa.
| | - R Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa.
| | - D Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa.
| | - G Turchetti
- Institute of Management, Scuola Superiore Sant'Anna, Pisa.
| | - M Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa.
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Caminati A, Vigone B, Cozzaglio S, De Nigris P, Galetti I, Nunzio SD, Verzeletti V, Cighetti J, Garbagnati C, Paleari L, Tabaglio E, Pirri S. Expert opinion and patients' in-depth interviews on the impact of pulmonary complications in systemic sclerosis. Curr Med Res Opin 2021; 37:17-26. [PMID: 34726093 DOI: 10.1080/03007995.2021.1992370] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To qualitatively explore the perceptions and opinions of experts dealing with systemic sclerosis (SSc) and patients with SSc on the impact of the disease and pulmonary complications on economic status, psycho-social wellbeing and the diagnostic and therapeutic journey, and to identify which strategies/interventions may be useful to address patients' and their family's needs. METHODS An expert meeting was conducted using the NGT to discuss the consequences of pulmonary complications on the Italian SSc community. The direct experience of five patients with SSc and pulmonary complications was described through in-depth interviews conducted by psychologists. RESULTS The experts' meeting and patients' in-depth interviews underline the complexity of SSc and the consequences of pulmonary involvement on patients' and caregivers' health-related quality of life, working ability, psychological wellbeing and social interactions. Panellists suggest that improved communication between physicians, associations and institutions could help protect the working status of patients with SSc. Granting patients disability benefits, providing access to part-time jobs and productivity-focused training could also help decrease the economic burden of the disease. A multidisciplinary approach is recommended to reduce treatment burden, together with the implementation of standard diagnostic and therapeutic paths and increased use of telemedicine via platforms that ensure secure health data sharing. Both patients and caregivers may benefit from psychological support. CONCLUSION SSc and pulmonary fibrosis have profound consequences on patients' and caregivers' health-related quality of life, working ability, psychological wellbeing and social interactions. Some activities may help patients and families deal with these aspects of the disease.
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Affiliation(s)
- Antonella Caminati
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria, Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe, MultiMedica IRCCS, Milan, Italy
| | - Barbara Vigone
- Scleroderma Unit, Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy
- UOC Medicina Generale Allergologia e Immunologia Clinica, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | - Sergio Cozzaglio
- Gruppo Italiano per la Lotta alla Sclerodermia (GILS), Milano, Italy
| | | | - Ilaria Galetti
- Gruppo Italiano per la Lotta alla Sclerodermia (GILS), Milano, Italy
| | | | | | | | - Carla Garbagnati
- Gruppo Italiano per la Lotta alla Sclerodermia (GILS), Milano, Italy
| | - Laura Paleari
- Gruppo Italiano per la Lotta alla Sclerodermia (GILS), Milano, Italy
| | | | - Salvatore Pirri
- Institute of Management, Scuola Superiore Sant'Anna di Pisa, Pisa, Italy
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Pirri S, Marinello D, Lorenzoni V, Andreozzi G, Bazzani A, Del Bianco A, Turchetti G, Mosca M, Talarico R. Adherence to treatment in Behçet's syndrome: a multi-faceted issue. Clin Exp Rheumatol 2021; 39 Suppl 132:88-93. [DOI: 10.55563/clinexprheumatol/1lx7a5] [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] [Received: 07/28/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Salvatore Pirri
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Diana Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | - Gianni Andreozzi
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Andrea Bazzani
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Alessandra Del Bianco
- Associazione S.I.M.B.A (Associazione Italiana Sindrome e Malattia di Behçet), Pontedera, Italy
| | | | - Marta Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, and Rheumatology Unit, University of Pisa, Italy
| | - Rosaria Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
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Talarico R, Cannizzo S, Lorenzoni V, Marinello D, Palla I, Pirri S, Ticciati S, Trieste L, Triulzi I, Terol E, Bucher A, Turchetti G. Correction to: RarERN Path: a methodology towards the optimisation of patients' care pathways in rare and complex diseases developed within the European Reference Networks. Orphanet J Rare Dis 2021; 16:146. [PMID: 33752690 PMCID: PMC7986507 DOI: 10.1186/s13023-021-01778-5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Rosaria Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, 56126, Pisa, Italy
| | - Sara Cannizzo
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà, 33, 56127, Pisa, Italy
| | - Valentina Lorenzoni
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà, 33, 56127, Pisa, Italy
| | - Diana Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, 56126, Pisa, Italy
| | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà, 33, 56127, Pisa, Italy
| | - Salvatore Pirri
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà, 33, 56127, Pisa, Italy
| | - Simone Ticciati
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, 56126, Pisa, Italy
| | - Leopoldo Trieste
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà, 33, 56127, Pisa, Italy
| | - Isotta Triulzi
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà, 33, 56127, Pisa, Italy
| | | | - Anna Bucher
- DG Health and Food Safety, 1000, Brussels, Belgium
| | - Giuseppe Turchetti
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà, 33, 56127, Pisa, Italy.
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Lorenzoni V, Pirri S, Turchetti G. Cost-Effectiveness of Direct Non-Vitamin K Oral Anticoagulants Versus Vitamin K Antagonists for the Management of Patients with Non-Valvular Atrial Fibrillation Based on Available "Real-World" Evidence: The Italian National Health System Perspective. Clin Drug Investig 2021; 41:255-267. [PMID: 33587284 PMCID: PMC7946694 DOI: 10.1007/s40261-021-01002-z] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVE The increasing availability of real-world evidence (RWE) about safety and effectiveness of direct non-vitamin K oral anticoagulants (DOACs) for the management of atrial fibrillation (AF) offers the opportunity to better understand the clinical and economic implications of DOACs versus vitamin K antagonists (VKAs). The objective of this study was to compare the economic implications of DOACs and VKAs using data from real-world evidence in patients with AF. METHODS A Markov model simulating the lifetime course of patients diagnosed with non-valvular AF was used to evaluate the cost-effectiveness of DOACs (i.e., rivaroxaban, dabigatran and apixaban) versus VKAs from the Italian National Health System (INHS) perspective. The model was made up of data from the literature and a meta-analysis of RWE on the incidence of stroke/systemic embolism (SE), major bleeding (MB), intracranial haemorrhage (ICH) and all-cause mortality (ACM); direct costs included drug costs, costs for drug monitoring, and management of events from official national lists. One-way and probabilistic sensitivity analyses (PSA) were used to assess the robustness of the results. RESULTS Results from the meta-analysis showed that apixaban had a high probability of being the most effective for stroke/SE, MB and ACM. Despite their higher acquisition costs, the cost-effectiveness analysis showed all DOACs involved a saving when compared with VKAs, with per-patient savings ranging between €4647 (rivaroxaban) to €6086 (apixaban). Moreover, all DOACs indicated a gain both in quality-adjusted life-years and life-years. According to PSA, findings related to apixaban were consistent, while for dabigatran and rivaroxaban PSA revealed a higher degree of uncertainty. CONCLUSIONS The beneficial effect of DOACs on containing events showed in RWE had the potential to offset drug-related costs, thus improving the sustainability of treatment for non-valvular AF in daily clinical practice.
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Affiliation(s)
- Valentina Lorenzoni
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy.
| | - Salvatore Pirri
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy
| | - Giuseppe Turchetti
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy
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Talarico R, Cannizzo S, Lorenzoni V, Marinello D, Palla I, Pirri S, Ticciati S, Trieste L, Triulzi I, Terol E, Bucher A, Turchetti G. RarERN Path: a methodology towards the optimisation of patients' care pathways in rare and complex diseases developed within the European Reference Networks. Orphanet J Rare Dis 2020; 15:347. [PMID: 33317578 PMCID: PMC7734838 DOI: 10.1186/s13023-020-01631-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 02/27/2020] [Accepted: 11/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2017, the European Commission has launched the European Reference Networks (ERNs), virtual networks involving healthcare providers across Europe. The aim of the ERNs is to tackle complex and rare diseases and conditions that require highly specialized treatment and a concentration of knowledge and resources. The ERN on rare and complex connective tissue and musculoskeletal diseases (ERN ReCONNET) is one of the 24 ERNs approved that aims to improve the management of Rare and Complex Connective Tissue and Musculoskeletal Diseases. OBJECTIVE The RarERN Path methodology aims to create a single reference organisational model for patients' care pathways which, if applied in different contexts, helps to ensure an improved, cost-effective and patient-centred equal care to rare and complex diseases. METHODS Starting from existing standard methods for the creation and elaboration of patients' care pathways, a specific methodology was created in order to take advantage of the distinctive and peculiar characteristics of the ERNs. Specifically, the development of the RarERN Path methodology involved different stakeholders: health economists, clinicians and researchers expert in rare and complex diseases, communication experts, experts in patients' involvement and narrative medicine and policy-makers. RESULTS The RarERN Path methodology foresees six consecutive phases, each with different and specific aims. Specifically, the six phases are represented by: Phase 1-mapping of existing patients' care pathways and patients' stories; Phase 2-design of an optimised common patients' care pathway; Phase 3-consensus on an optimised common patients' care pathway; Phase 4-key performance indicators definition; Phase 5-refinement; Phase 6-pilot phase (optional). CONCLUSION The application of RarERN Path to the different disease-specific and geographical contexts would help to ensure an improved, cost-effective and patient-centred equal care to rare and complex diseases across Europe as well as a possible tangible action towards the integration of ERNs into the different European healthcare systems.
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Affiliation(s)
- Rosaria Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, 56126, Pisa, Italy
| | - Sara Cannizzo
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy
| | - Valentina Lorenzoni
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy
| | - Diana Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, 56126, Pisa, Italy
| | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy
| | - Salvatore Pirri
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy
| | - Simone Ticciati
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, 56126, Pisa, Italy
| | - Leopoldo Trieste
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy
| | - Isotta Triulzi
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy
| | | | - Anna Bucher
- DG Health and Food Safety, 1000, Brussels, Belgium
| | - Giuseppe Turchetti
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy.
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Cannizzo S, Palla I, Pirri S, Triulzi I, Carta C, Taruscio D, Turchetti G. One year in review 2020: economic and organisational aspects in rare and complex connective tissue diseases. Clin Exp Rheumatol 2020; 38:1037-1045. [PMID: 33242303] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/27/2020] [Indexed: 06/11/2023]
Abstract
Rare and complex connective tissue diseases (rCTDs) encompass a considerable number of diseases and syndromes and their variability highly impacts on the clinical management, resulting in variable economic and organisational burden that might represent a challenge for healthcare systems. This paper is aimed at providing an overview of the most recent evidence regarding the economic and organisational impact of rCTDs. In particular, this work discusses the most relevant data on specific aspects related to health economics in rCTDs published in 2019.
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Affiliation(s)
- Sara Cannizzo
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Salvatore Pirri
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Isotta Triulzi
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Claudio Carta
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Domenica Taruscio
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
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Pirri S, Lorenzoni V, Andreozzi G, Mosca M, Turchetti G. Topic Modeling and User Network Analysis on Twitter during World Lupus Awareness Day. Int J Environ Res Public Health 2020; 17:E5440. [PMID: 32731600 PMCID: PMC7432829 DOI: 10.3390/ijerph17155440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
Twitter is increasingly used by individuals and organizations to broadcast their feelings and practices, providing access to samples of spontaneously expressed opinions on all sorts of themes. Social media offers an additional source of data to unlock information supporting new insights disclosures, particularly for public health purposes. Systemic lupus erythematosus (SLE) is a complex, systemic autoimmune disease that remains a major challenge in therapeutic diagnostic and treatment management. When supporting patients with such a complex disease, sharing information through social media can play an important role in creating better healthcare services. This study explores the nature of topics posted by users and organizations on Twitter during world Lupus day to extract latent topics that occur in tweet texts and to identify what information is most commonly discussed among users. We identified online influencers and opinion leaders who discussed different topics. During this analysis, we found two different types of influencers that employed different narratives about the communities they belong to. Therefore, this study identifies hidden information for healthcare decision-makers and provides a detailed model of the implications for healthcare organizations to detect, understand, and define hidden content behind large collections of text.
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Affiliation(s)
- Salvatore Pirri
- Institute of Management, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (V.L.); (G.A.); (G.T.)
| | - Valentina Lorenzoni
- Institute of Management, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (V.L.); (G.A.); (G.T.)
| | - Gianni Andreozzi
- Institute of Management, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (V.L.); (G.A.); (G.T.)
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, Università di Pisa, 56126 Pisa, Italy;
| | - Giuseppe Turchetti
- Institute of Management, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (V.L.); (G.A.); (G.T.)
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Pirri S, Lorenzoni V, Turchetti G. Scoping review and bibliometric analysis of Big Data applications for Medication adherence: an explorative methodological study to enhance consistency in literature. BMC Health Serv Res 2020; 20:688. [PMID: 32709237 PMCID: PMC7379348 DOI: 10.1186/s12913-020-05544-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 07/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medication adherence has been studied in different settings, with different approaches, and applying different methodologies. Nevertheless, our knowledge and efficacy are quite limited in terms of measuring and evaluating all the variables and components that affect the management of medication adherence regimes as a complex phenomenon. The study aim is mapping the state-of-the-art of medication adherence measurement and assessment methods applied in chronic conditions. Specifically, we are interested in what methods and assessment procedures are currently used to tackle medication adherence. We explore whether Big Data techniques are adopted to improve decision-making procedures regarding patients' adherence, and the possible role of digital technologies in supporting interventions for improving patient adherence and avoiding waste or harm. METHODS A scoping literature review and bibliometric analysis were used. Arksey and O'Malley's framework was adopted to scope the review process, and a bibliometric analysis was applied to observe the evolution of the scientific literature and identify specific characteristics of the related knowledge domain. RESULTS A total of 533 articles were retrieved from the Scopus academic database and selected for the bibliometric analysis. Sixty-one studies were identified and included in the final analysis. The Morisky medication adherence scale (36%) was the most frequently adopted baseline measurement tool, and cardiovascular/hypertension disease, the most investigated illness (38%). Heterogeneous findings emerged from the types of study design and the statistical methodologies used to assess and compare the results. CONCLUSIONS Our findings reveal a lack of Big Data applications currently deployed to address or measure medication adherence in chronic conditions. Our study proposes a general framework to select the methods, measurements and the corpus of variables in which the treatment regime can be analyzed.
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Affiliation(s)
- Salvatore Pirri
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
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Cannizzo S, Lorenzoni V, Palla I, Pirri S, Trieste L, Triulzi I, Turchetti G. Rare diseases under different levels of economic analysis: current activities, challenges and perspectives. RMD Open 2018; 4:e000794. [PMID: 30488003 PMCID: PMC6241967 DOI: 10.1136/rmdopen-2018-000794] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/08/2018] [Accepted: 10/08/2018] [Indexed: 01/08/2023] Open
Abstract
Rare diseases imply clinical and economic burden as well as a significant challenge for health systems. One relevant objective of the activities planned within the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET) is to address the economic dimensions of rare diseases to identify, develop and suggest strategies to improve research and patients' access to orphan drugs (ODs) and highly specialised health technologies. This paper presents a preliminary review of the existing policies on rare diseases in the countries of the Network members. It also introduces and discusses the theme of how to perform health economic evaluations of rare diseases and of existing or new treatments for rare diseases. To obtain a preliminary overview aiming at defining the state of the art of rare diseases policies and initiatives in ERN ReCONNET countries, we collected and analysed the rare diseases national plans of all the eight countries of the ERN ReCONNET participants. The preliminary overview that has been performed showed that in all the ERN ReCONNET countries are in place national plans for rare diseases; however, heterogeneity exists in the reimbursement of ODs, direct provision by the healthcare system, involvement of patients' associations in decision making and implementation of clinical practice guidelines.
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Affiliation(s)
- Sara Cannizzo
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | | | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Salvatore Pirri
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Leopoldo Trieste
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Isotta Triulzi
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
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Cannizzo S, Lorenzoni V, Palla I, Pirri S, Trieste L, Triulzi I, Turchetti G. Rare diseases under different levels of economic analysis: current activities, challenges and perspectives. RMD Open 2018. [PMID: 30488003 DOI: 10.1136/rmdopen-2018-000794.pmid:30488003;pmcid:pmc6241967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023] Open
Abstract
Rare diseases imply clinical and economic burden as well as a significant challenge for health systems. One relevant objective of the activities planned within the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET) is to address the economic dimensions of rare diseases to identify, develop and suggest strategies to improve research and patients' access to orphan drugs (ODs) and highly specialised health technologies. This paper presents a preliminary review of the existing policies on rare diseases in the countries of the Network members. It also introduces and discusses the theme of how to perform health economic evaluations of rare diseases and of existing or new treatments for rare diseases. To obtain a preliminary overview aiming at defining the state of the art of rare diseases policies and initiatives in ERN ReCONNET countries, we collected and analysed the rare diseases national plans of all the eight countries of the ERN ReCONNET participants. The preliminary overview that has been performed showed that in all the ERN ReCONNET countries are in place national plans for rare diseases; however, heterogeneity exists in the reimbursement of ODs, direct provision by the healthcare system, involvement of patients' associations in decision making and implementation of clinical practice guidelines.
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Affiliation(s)
- Sara Cannizzo
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Salvatore Pirri
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Leopoldo Trieste
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Isotta Triulzi
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
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Cau M, Puxeddu R, Tore G, Pirri S, Pusceddu Z, Aste C, Carta F, Summo O, Tandurella I, Carta P, Aste M, Defraia E, Gutman G, Mascia L, Mascia M, Ghiani M. Skin rash and response to cetuximab treatment: a retrospective single-center analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx430.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Del Vecchio P, Di Minin A, Petruzzelli AM, Panniello U, Pirri S. Big data for open innovation in SMEs and large corporations: Trends, opportunities, and challenges. Creat Innov Manag 2017. [DOI: 10.1111/caim.12224] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Alberto Di Minin
- Department of Management; Scuola Superiore Sant'Anna; Pisa Italy
| | | | | | - Salvatore Pirri
- Department of Management; Scuola Superiore Sant'Anna; Pisa Italy
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Buscemi C, Pirri S, Mangione D, Giarratano A. Modifications of coagulation imbalance during antithrombin treatment in preeclamptic patients: our experience. Crit Care 2008. [PMCID: PMC4088584 DOI: 10.1186/cc6434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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16
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Pirri S, Mastrandrea R, Barcia A, Mazzola A, Salemi S. Effects of the clinical characteristics of the organ donor on the long-term results of the transplant and survival of the patient, with particular reference to kidney transplants. Crit Care 2007. [PMCID: PMC4095525 DOI: 10.1186/cc5632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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17
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Puxeddu R, Pirri S, Bacchi PC, Salis G, Ledda GP. Endoscopic CO2 laser treatment of supraglottic carcinoma. Acta Otorhinolaryngol Ital 2003; 23:459-66. [PMID: 15198049] [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: 04/29/2023]
Abstract
Aim of the study was to evaluate whether laser endoscopic microsurgery is a reliable and appropriate approach to treatment of laryngeal supraglottic cancer. A retrospective study was made of 12 patients (11 M/1 F; mean age 62.5 years) treated from December 1995 to October 2001 in the Department of Surgical Sciences and Organ Transplantations, Section of Otorhinolaryngology, University of Cagliari, Italy. Surgical steps and oncologic results are reported. These 12 patients with supraglottic cancer underwent transoral laser surgery (TNM classification: T1, 3 patients; T2, 9 patients; N-, 9 patients; N+, 3 patients; M-, 12 patients). On the basis of the different subsites removed, the following resections were performed: 1 limited excisional biopsy (false chord), 3 wide excisional biopsies (2 or 3 subsites), 2 simple epiglottectomies, 1 extended epiglottectomy, 3 horizontal supraglottic laryngectomies, and 2 horizontal supraglottic laryngectomies that were extended to the anterior commissure and to one arytenoid, respectively. Five patients underwent functional neck dissection, and one patient underwent post-operative radiotherapy at sites of tumour and lymph nodes. Temporary tracheotomy was carried out in 10 patients. Mean follow-up was 33.3 months. No local recurrences were noted. Local control was thus 100%. Aspiration was the main post-operative problem, but there were no cases of aspiration-associated pneumonia. Moreover, no patient needed laryngectomy or a permanent tracheotomy for aspiration. In conclusion, although our experience with supraglottic cancers treated by endoscopy is still too limited to confirm the definitive oncologic validity of this type of surgery, in our hands, it seems to be a reasonable tool in selected cases and a safe, time- and cost-effective alternative to traditional surgery or radiotherapy for selected supraglottic carcinomas.
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Affiliation(s)
- R Puxeddu
- Department of Surgical Sciences and Organ Transplantations, Section of Otorhinolaryngology, University of Cagliari, Italy.
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