These are pathologies that still firmly occupy the first position in Italy as causes of death and disability
The guideline document was presented at the meeting Towards a National Cardio-Cerebrovascular Plan – If not now when? promoted by the Parliamentary Intergroup for cardio and cerebrovascular diseases in collaboration with The European House – Ambrosetti.
The areas of intervention identified concern: primary and secondary prevention, adherence to therapies, access to technological and pharmacological innovation, telemedicine, continuity of care and patient empowerment. Prevention is an area in which there is still a lot to do if we consider that only 26% of hypertensive patients and about one third of patients with hypercholesterolemia are aware of their condition and adequately treated. A problem that assumes particular importance in the secondary and tertiary prevention interventions implemented to avoid or slow down the progression and relapse of cardio and cerebrovascular diseases. Here the country suffers significant delays – underlines Michele Gulizia, of the Garibaldi-Nesima Hospital in Catania and President of the Foundation for your Heart, HCF ANMCO – For example, the DA VINCI study which aimed to see the achievement of therapeutic targets with respect to values of cholesterolemia shows how this happens for LDL cholesterol only in 18% of patients at very high cardiovascular risk and that 58% of those who reach the target do so thanks to the combination with a class of drugs that in Italy is underutilized, the inhibitors of the PCSK9.
The loss of therapeutic adherence it represents another extremely delicate aspect. The data indicate that there is a reduction gradient in therapeutic adherence with increasing age, as there are geographical differences, characterized by better adherence in the northern regions than in the southern ones and how women tend to be more adherent than men . The scientific literature shows that between the lower and the higher level of adherence there is a 38% reduction in costs in patients with hypercholesterolemia and 25% in patients with hypertension, which largely compensates for the increase in costs due to increased consumption. of drugs or the consumption of more expensive drugs, affirms Pasquale Perrone Filardi, of the AOU Federico II of Naples and elected President of SIC. Critical points were also identified in the other areas of the project: Despite the benefits brought, in our country there are still delays in accessing innovation mainly due to a greater focus on the cost of the single therapy / technology rather than on the value it generates on Giovanni Esposito, of the AOU Federico II of Naples and President of the GISE, affirms the entire treatment path.
Just remember the TAVI, a technique that involves the replacement of the aortic valve with a trans catheter approach, still largely underutilized in our country despite the advantages in terms of reducing the duration of surgery and hospitalization and the lower rate of re-hospitalizations. The Covid-19 pandemic has boosted the spread of telemedicine. If all 116 responding arrhythmological centers had recourse to remote monitoring of implantable devices even before the pandemic – underlines Roberto De Ponti, of the University of Insubria and President of AIAC – 71.6% increased their use and 31 % of the centers activated an additional tele-visit service. A diffusion that collides with some obstacles such as the difficulty in having tariffs for remote monitoring of implantable devices, available only in 7 Regions. A series of indications for the implementation of the Plan which were received with interest by the politicians present. A national plan represents the concrete response to problems that arise along all the stages of the care process, from prevention – primary and secondary – and early diagnosis, to management and follow-up up to home care – underlined Rossana Boldi, President of the Intergroup and Vice-President of the Social Affairs Commission -. I believe that this is the right moment to make it happen because we are on the eve of a small or big revolution in terms of territorial and hospital assistance. This is therefore the time to make proposals in order to understand how they can work alongside the projects that are within the PNRR.
November 29, 2021 (change November 29, 2021 | 18:23)
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