Heart failure, new ad hoc diagnostic path in the Marche region

Heart failure is a very common problem and is one of the major causes of hospital admissions: it affects 1-2% of the general population, with an increasing incidence in old age. A complex pathology from the point of view of patient care in different settings: from the management of the most acute phases in the hospital to that of chronicity with local structures. Furthermore, diagnosis and treatment absorb important resources of health systems (around 2.5% of health expenditure in European health systems). Hence the need for the Marche Region to adopt, with an ad hoc resolution, the new Diagnostic Therapeutic Assistance Path (PDTA) for the management of the adult patient with heart failure in the Marche region. This need has been further strengthened in the last two years, as welfare problems have worsened due to the pandemic. This is what is reported in an article published on the website of ‘Allies for Health’, the portal dedicated to medical-scientific information created by Novartis. The Marche Region – reads the article – has a new welfare organizational model defined, for the first time, with the direct contribution of all the professionals involved in the management of patients with heart failure. The innovative aspect concerns the way in which it was possible to prepare the Pdta, actively involving many of the main operators of the regional health system. Not only. The resolution was preceded by a work carried out within the School of Operational Health Technology Assessment, born in 2013 from an idea of ​​its scientific manager – the engineer Giancarlo Conti – as a scientific training initiative “in the field” which aims to fill a cultural gap in public health institutions, providing operators with an overall picture of the Health Technology Assessment (Hta) process – i.e. health technology assessment – and the tools to concretely adopt this approach. Thanks to the HTA School, it has been possible to bring together the key figures in the care pathway of heart failure: cardiologists, general practitioners, palliative care specialists, nurses, pharmacists, engineers and economists. The participants – reports Allies for Health – shared information and proposals in the classroom, discussing them thoroughly in a consensus conference between sector experts. A wealth of information made available to the working group in charge of preparing the Pdta (coordinated for the Region by Claudio Martini) then adopted in September 2021 almost simultaneously with the publication of the report. In practice, the Pdta is based on a ‘bottom up’ approach, that is elaborated starting from the experiences of the professionals directly involved in the management of the patient, a modality that makes what it contains realistic and feasible contrary to many ‘top down’ initiatives which, based on abstract definitions of processes that do not start from the details, often encounter resistance from the operators responsible for carrying them out. For this edition, the course, which was divided into seven meetings (of 4 hours each) for the duration of 5 months, involved about 50 participants. A final element – underlines the article – is the impact that these paths can have on the sick and on all citizens. Not only that, within the School, representatives of the civil world are also invited to provide their contribution (represented by the Regional Secretariat of Cittadinanzattiva, patient associations) but the Pdta adopted is strongly based on the analyzes carried out on the real situation of the Region and on the realistically achievable potential. The full article is available at: https://www.alleatiperlasalute.it/il-dialogo-conta/scompenso-cardiaco-nelle-marche-nuovo-percorso-diagnoroso-terapeutico