Appropriatezza prescrittiva e corretta informazione (Regione Campania) - 28 maggio 2024

Motore Sanità


Summary

The video delves into the complexities of managing chronic pain, emphasizing the crucial role of appropriate prescription practices and patient care. It discusses the challenges in pain management, including economic impacts and rational drug choices while stressing evidence-based practices. The importance of multidisciplinary approaches, technological advancements, and collaboration between healthcare professionals for optimizing patient outcomes is highlighted. Additionally, the speaker addresses the significance of informed decision-making, responsible medication use, and the necessity for training and cultural changes in healthcare management to enhance patient care quality. The video underlines the need for a structured organizational framework and digital platforms to improve patient outcomes and streamline treatment processes in healthcare.


Introduction to the Event

The speaker welcomes the audience to the event titled "Appropriate Prescribed Care and Correct Information: Key Factors in Managing Chronic Pain." The event is described as a work in progress with attendees gradually arriving. The speaker expresses gratitude for being back in Naples after experiencing hail in Turin. The atmosphere is highlighted as fantastic.

Acknowledgment and Introductions

Various individuals, including Valeria Ciarambino, Vice President of the Regional Council of Campania, and other regional council members and healthcare professionals, are acknowledged for their presence at the event.

Role of Medical Professionals in Pain Management

The roles of different healthcare professionals, including pharmacists, general practitioners, and medical directors, in prescribing and managing chronic pain are discussed. The importance of appropriate prescription and patient care is emphasized.

Challenges in Managing Chronic Pain

The challenges of managing chronic pain, including the economic impact, the use of medications, and rational drug choices, are highlighted. The prevalence of moderate chronic pain and its economic burden are addressed.

Prescription Practices and Rational Drug Choices

The importance of rational drug choices in managing mild to moderate chronic pain is discussed. The role of paracetamol as the first-line treatment and the implications of inappropriate prescriptions, especially regarding non-steroidal anti-inflammatory drugs (NSAIDs), are emphasized.

Guidelines and Therapy for Chronic Pain

Guidelines for non-oncological pain therapy are mentioned, focusing on the importance of access to care, continuity of assistance, and the role of primary care physicians in chronic pain management. The significance of evidence-based practices and informed decision-making is highlighted.

Considerations for Patients with Chronic Pain

The impact of chronic pain on patients, including its economic and social consequences, is discussed. The need for appropriate prescription practices, therapeutic reconciliation, and the consideration of individual patient characteristics is emphasized.

Challenges in Therapeutic Reconciliation

The challenges of therapeutic reconciliation in elderly patients and the importance of considering drug interactions, patient compliance, and gender-specific medication effects are addressed. The speaker stresses the need for a multidisciplinary approach to medication management.

Focus on Women's Health and Medication Interactions

The speaker highlights the importance of considering gender-specific medication effects, adverse reactions in women, and the need for adequate monitoring of medication use. The concept of "deprescribing" unnecessary medications is discussed to optimize treatment outcomes.

Telemedicine and Collaborative Care

The role of telemedicine in facilitating collaboration between primary care physicians and clinical pharmacologists for optimizing drug therapy is discussed. The speaker emphasizes the value of technological advancements in enhancing healthcare delivery and patient outcomes.

Personal Experience with Palliative Care

The speaker shares a recent personal experience with a loved one facing oncological pain and palliative care. They emphasize the loneliness and lack of adequate assistance in such situations, highlighting the need for improved pain management in chronic benign pain as well.

Cultural Change in Healthcare Management

The importance of a cultural change in healthcare management is discussed, focusing on the role of anesthetists and the need for a shift towards humanizing care. The speaker emphasizes the significance of pain therapy in oncological, palliative, and chronic benign pain cases as a key aspect of humanized healthcare.

Importance of Training and Cultural Paradigm Shift

The speaker stresses the need for training and a shift in the medical approach to patient care. They highlight the importance of mental attitude and medical training in enhancing the quality of healthcare services, particularly in pain management.

Commitment to Better Healthcare

The speaker expresses their commitment to improving healthcare services and invites collaboration for enhancing the healthcare system. They emphasize the importance of patient feedback and continuous improvement in healthcare practices.

Challenges in Health Information and Self-Prescription

The discussion revolves around challenges in health information dissemination, self-prescription practices, and the impact of misinformation on healthcare. The speaker highlights the need for informed decision-making and responsible medication use.

Impact of Inappropriate Medication Use

Discusses the impact of using prescribed medications incorrectly, leading to financial costs and potential side effects. Emphasizes the importance of appropriate prescription practices in pharmacies.

Challenges in Prescriptive Practices

Addresses the need for organizational efficiency in prescription practices, specifically focusing on the role of general practitioners and specialists in managing pain and chronic conditions.

Improving Organizational Appropriateness

Highlights the importance of enhancing organizational structures to ensure timely access to healthcare services and proper coordination between medical professionals, particularly in pain management.

Evaluating Prescriptive Appropriateness

Examines the prescription practices in a specific region, emphasizing the need for medical practitioners to prescribe medication in line with appropriate guidelines to avoid unnecessary costs and risks.

Synergistic Healthcare Network

Discusses the necessity of establishing a synergistic network between general practitioners, specialists, and pharmacies to enhance patient care and streamline treatment processes.

Addressing Pain Management Challenges

Explores the complexities of pain management, emphasizing the importance of creating a structured organizational framework to improve patient outcomes and quality of care.

Enhancing Healthcare System Efficiency

Focuses on the need to improve the efficiency of the healthcare system by empowering general practitioners, optimizing resource allocation, and enhancing communication between healthcare providers.

Optimizing Pain Relief Strategies

Discusses the need to optimize pain relief strategies through improved organizational structures, enhanced communication channels between healthcare professionals, and proactive patient management approaches.

Improving Prescription Appropriateness

Examines the prescription data and highlights the importance of prescribing medications appropriately to ensure effective and safe use of medication for patients.

Terapia Principale per le Complicanze della Malattia

La terapia principale per le complicanze della malattia è diventata fondamentale, con un focus sui ricoveri e le complicanze emerse nella regione.

Modello di Organizzazione dei Medici

Sottolinea l'evoluzione del modello di organizzazione dei medici, con particolare attenzione alla Regione e ai codici bianchi.

Prescrizioni di Fans e Antibiotici

Discussione sulle prescrizioni di fans per medici, con particolare focus sull'uso di gastroprotezione e antibiotici dopo l'uso dei fans.

Prescrizioni di Farmaci e Ibuprofene

Analisi dettagliata sulle prescrizioni di farmaci con evidenza sull'utilizzo dell'ibuprofene e l'aumento della prescrizione del ketoprofene rispetto agli ultimi 4 anni.

Utilizzo degli Antiinfiammatori e Gastroprotezione

Approfondimento sull'utilizzo degli antiinfiammatori, con l'enfasi sull'importanza della gastroprotezione e sull'uso responsabile di questi farmaci.

Gestione del Dolore Cronico e Prescrizioni Inappropriate

Ruolo della gestione del dolore cronico nell'identificare e controllare le prescrizioni inappropriate, con attenzione alla prescrizione di farmaci non conformi alle linee guida.

Medicina Generale e Strumenti Digitali

Illustrazione dei ruoli e delle opportunità offerti dalle piattaforme digitali nella medicina generale, con un focus sull'innovazione e sull'evoluzione dei modelli organizzativi.

Integrazione dei Database Clinici e Crescita della Consapevolezza

Discussione sull'integrazione dei database clinici e sull'importanza di crescere nella consapevolezza professionale e nell'adozione di soluzioni tecnologiche innovative.

Collaboration with Family Doctors

Discussing the success and importance of collaboration with family doctors in using their own solutions to provide necessary information for institutional monitoring and data collection at a national level.

Functional Territorial Aggregations

Explaining the concept of functional territorial aggregations, focusing on the continuity of care, use of software solutions, and monitoring of health objectives and activities.

Integration of Digital Platforms

Highlighting the digital platform chosen for integrating clinical information and monitoring health objectives and activities, emphasizing the role of digital solutions in organizing care availability.

Role of Digital Platforms in Healthcare

Exploring the evolving role of digital platforms in healthcare, including monitoring health objectives, organization of activities, and integration with healthcare institutions.

Monitoring and Organizational Capacity

Discussing the importance of monitoring health objectives, activities, and organizational capacity within the digital platform used in healthcare settings for effective care management.

Expansion of Model to Other Regions

Explaining the necessity for other regions to replicate the successful model of functional territorial aggregations implemented in the Campania region in 2020, highlighting the need for structured regional decrees.

Adoption of Digital Platforms in Healthcare

Detailing the adoption of digital platforms in healthcare, focusing on the role of platforms in integrating clinical data, facilitating monitoring, and enhancing patient care through advanced tools like AI integration.

Monitoring Chronic Pain and Drug Therapy

Discussing the importance of monitoring chronic pain, appropriate drug therapy, and auditing prescriptions, emphasizing the role of digital platforms and collaboration between healthcare providers and institutions.

Il ruolo del medico nel consolidare il rapporto di fiducia

Il medico deve consolidare il rapporto di fiducia con i pazienti, trasformando la relazione e ripristinando la fiducia, evitando la medicalizzazione inutile e sviluppando conoscenze trasversali per un impatto socio-assistenziale significativo.

Comportamento responsabile del medico e utilizzo del linguaggio semplice

Il medico deve addestrare ad un comportamento responsabile, utilizzando un linguaggio semplice con i pazienti per facilitare la comprensione e la comunicazione efficace.

Utilizzo corretto dei farmaci e aree terapeutiche principali

Necessità di adeguata capacità diagnostica e terapeutica, differenza tra farmaci di automedicazione e prescrizione medica. Le principali aree terapeutiche trattate sono quelle cardiometaboliche, respiratorie, neurologiche e osteoarticolari.

Prevalenza del dolore e situazione in Italia

13 milioni di persone in Italia soffrono di dolore cronico, con una maggiore incidenza nelle fasce di età più anziane. Il dolore cronico è diffuso e coinvolge una vasta parte della popolazione.

Evidenze scientifiche sull'uso dei FANS per il trattamento del dolore cronico

Le evidenze scientifiche supportano l'uso dei FANS per il trattamento del dolore cronico con politerapia, evidenziando l'efficacia e la sicurezza di tali farmaci. L'aumento delle prescrizioni di FANS è stato rilevato, con un incremento significativo nella regione di Campania.

Nota 66 e indicazioni per l'uso dei FANS

La Nota 66 regola la prescrizione di farmaci antinfiammatori non steroidei (FANS) per limitare l'uso improprio e promuovere la sicurezza del paziente. Le indicazioni per l'uso corretto riguardano patologie come l'artrite reumatoide e la spondilite anchilosante.

Ruolo fondamentale della Nota 66 nella prescrizione sicura

La Nota 66 guida i medici nella prescrizione sicura dei FANS, minimizzando i rischi associati e garantendo un trattamento efficace per i pazienti. È importante seguire le linee guida per evitare conseguenze dannose per la salute.

Community Districts and Digitalization

Discussion on the importance of walking together in community districts, the risk of some districts progressing while others lag behind, and the need for collective governance and training.

Perception of District Roles

Perception issues within district roles, the importance of community-oriented structures, and the necessity of collective governance for effective district functioning.

Challenges in District Evolution

Challenges faced by districts, including administrative functions overshadowing healthcare services, lack of communication leading to divergence in goals, and the need for mandatory training.

Role of Community House and Hospital

Importance of the district in governing community houses and hospitals, the duties of district directors and delegates, and the essential need for unified district progress.

Current District Trends

Discussion on the current trend of districts moving towards administrative functions rather than community-focused healthcare, the importance of regaining focus on functional areas, and the need for informed discussions for sustainable healthcare practices.

Professional Insights and Advocacy

Personal insights and advocacy for prioritizing district healthcare over administrative tasks, the importance of experienced professionals initiating discussions, and the significance of consistent training in healthcare legislation and digital tools.

Promoting Training in Districts

Advocacy for utilizing districts for training sessions, fostering collaboration with competent citizens for effective healthcare, and emphasizing the role of community engagement in training programs.

Importance of Prescription Appropriateness

Discussion on prescription appropriateness monitoring, utilization of digital tools for collaborative training, and the role of medical professionals in ensuring appropriate prescriptions and treatments.

Management of Pharmaceutical Records

The professor anesthetist manages pharmaceutical records with ease compared to three years ago when they digitized the pharmaceutical handbook. The advancement in the Campania region allows for easier prescription of important drugs like opioids, highlighting the need for training in prescribing these medications.

Training on Drug Prescriptions

There is a need for training in drug prescriptions, especially for general practitioners, in managing chronic and oncological pain. Collaboration with the ASL Guido is requested to help provide education on the most suitable drugs for managing chronic oncological pain.

Implementation of Electronic Health Records

The implementation of Electronic Health Records (EHR) will benefit fragile patients requiring medication by tracking prescriptions effectively. It is emphasized that collaboration with districts and enhancing the IT infrastructure are essential for effective healthcare provision.

Audit and Education for General Practitioners

Efforts have been made to conduct audits and education for general practitioners to improve prescription appropriateness and address issues such as antibiotic usage. Continuous education and analysis of prescription patterns are crucial for enhancing healthcare services.

Challenges in Drug Prescriptions

Addressing challenges in drug prescriptions, especially concerning the cost for patients, the appropriateness of prescriptions, and the management of chronic pain conditions. The importance of collaboration, EHR utilization, and professional education is highlighted for effective healthcare provision.

Conclusion and Future Healthcare Models

The conclusion emphasizes the importance of collaborative approaches in discussing healthcare models and organizational structures to enhance healthcare services over the next two years. The focus is on listening to the needs of the population, integrating feedback, and ensuring patient-centric care.


FAQ

Q: What is the process of nuclear fusion?

A: Nuclear fusion is the process by which two light atomic nuclei combine to form a single heavier one while releasing massive amounts of energy.

Q: How is chronic pain management approached at the event?

A: Chronic pain management is approached through discussions on appropriate prescription practices, patient care, the roles of different healthcare professionals, rational drug choices, and the economic impact of managing chronic pain.

Q: What is the significance of rational drug choices in managing chronic pain?

A: Rational drug choices are important in managing mild to moderate chronic pain, with a focus on using medications like paracetamol as first-line treatments and avoiding inappropriate prescriptions, especially related to non-steroidal anti-inflammatory drugs (NSAIDs).

Q: What healthcare professionals are involved in prescribing and managing chronic pain?

A: Healthcare professionals such as pharmacists, general practitioners, and medical directors play crucial roles in prescribing and managing chronic pain, emphasizing the importance of appropriate prescription practices and patient care.

Q: What challenges are highlighted in chronic pain management?

A: Challenges in chronic pain management include the economic impact, use of medications, rational drug choices, prevalence of moderate chronic pain, and the need for individualized patient care while considering factors like drug interactions and patient compliance.

Q: How is the importance of evidence-based practices emphasized in chronic pain management?

A: The significance of evidence-based practices is highlighted for informed decision-making in chronic pain management to ensure optimal outcomes, patient safety, and effective treatment strategies.

Q: What role does the speaker stress in medication management?

A: The speaker stresses the need for a multidisciplinary approach to medication management, focusing on gender-specific medication effects, adverse reactions, deprescribing unnecessary medications, and utilizing telemedicine for optimizing drug therapy.

Q: How is the concept of 'deprescribing' explained in optimizing treatment outcomes?

A: Deprescribing refers to the process of discontinuing or reducing unnecessary medications to improve treatment outcomes, especially relevant in chronic pain management to prevent potential side effects and financial costs associated with inappropriate medication use.

Q: What is highlighted regarding the impact of misinformation on healthcare?

A: The impact of misinformation on healthcare is discussed, emphasizing the importance of informed decision-making, responsible medication use, and the risks associated with using prescribed medications incorrectly, leading to potential side effects and financial costs.

Q: How are prescription practices addressed in the discussion?

A: The discussion addresses the significance of appropriate prescription practices in pharmacies, the importance of organizational efficiency in prescription practices, and the role of general practitioners and specialists in managing pain and chronic conditions with adherence to guidelines.

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