Objectives To compare time intervals to diagnosis and treatment, tumor characteristics, and management in patients with primary urinary bladder cancer, diagnosed before and after the implementation of a standardized care pathway (SCP) in Sweden. Materials and methods Data from the Swedish National Register of Urinary Bladder Cancer was studied before (2011-2015) and after (2016-2019) SCP. Data about time from referral to transurethral resection of bladder tumor (TURBT), patients and tumor characteristics, and management were analyzed. Subgroup analyses were performed for cT1 and cT2-4 tumors. Results Out of 26,795 patients, median time to TURBT decreased from 37 to 27 days after the implementation of SCP. While the proportion of cT2-T4 tumors decreased slightly (22-21%, p < 0.001), this change was not stable over time and the proportions cN + and cM1 remained unchanged. In the subgroups with cT1 and cT2-4 tumors, the median time to TURBT decreased and the proportions of patients discussed at a multidisciplinary team conference (MDTC) increased after SCP. In neither of these subgroups was a change in the proportions of cN + and cM1 observed, while treatment according to guidelines increased after SCP in the cT1 group. Conclusion After the implementation of SCP, time from referral to TURBT decreased and the proportion of patients discussed at MDTC increased, although not at the levels recommended by guidelines. Thus, our findings point to the need for measures to increase adherence to SCP recommendations and to guidelines. ; Funding Agencies|Swedish government [ALFGBG-873181]; Swedish county councils, the ALF-agreement [ALFGBG-873181]; Department of Research and Development, NU-Hospital GroupNU Hospital Group
In: Bousquet , J J , Schünemann , H J , Togias , A , Erhola , M , Hellings , P W , Zuberbier , T , Agache , I , Ansotegui , I J , Anto , J M , Bachert , C , Becker , S , Bedolla-Barajas , M , Bewick , M , Bosnic-Anticevich , S , Bosse , I , Boulet , L P , Bourrez , J M , Brusselle , G , Chavannes , N , Costa , E , Cruz , A A , Czarlewski , W , Fokkens , W J , Fonseca , J A , Gaga , M , Haahtela , T , Illario , M , Klimek , L , Kuna , P , Kvedariene , V , Le , L T T , Larenas-Linnemann , D , Laune , D , Lourenço , O M , Menditto , E , Mullol , J , Okamoto , Y , Papadopoulos , N , Pham-Thi , N , Picard , R , Pinnock , H , Roche , N , Roller-Wirnsberger , R E , Rolland , C , Samolinski , B , Sheikh , A , Toppila-Salmi , S , Tsiligianni , I , Bindslev-Jensen , C , Eller , E , Ulrik , C S & ARIA Study Group 2019 , ' Next-generation ARIA care pathways for rhinitis and asthma : a model for multimorbid chronic diseases ' , Clinical and Translational Allergy , vol. 9 , 44 . https://doi.org/10.1186/s13601-019-0279-2
Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
International audience ; Background : In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main body : As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care.Conclusion : In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
International audience ; Background : In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main body : As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care.Conclusion : In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
In: Bousquet , J J , Schünemann , H J , Togias , A , Erhola , M , Hellings , P W , Zuberbier , T , Agache , I , Ansotegui , I J , Anto , J M , Bachert , C , Becker , S , Bedolla-Barajas , M , Bewick , M , Bosnic-Anticevich , S , Bosse , I , Boulet , L P , Bourrez , J M , Brusselle , G , Chavannes , N , Costa , E , Cruz , A A , Czarlewski , W , Fokkens , W J , Fonseca , J A , Gaga , M , Haahtela , T , Illario , M , Klimek , L , Kuna , P , Kvedariene , V , Le , L T T , Larenas-Linnemann , D , Laune , D , Lourenço , O M , Menditto , E , Mullol , J , Okamoto , Y , Papadopoulos , N , Pham-Thi , N , Picard , R , Pinnock , H , Roche , N , Roller-Wirnsberger , R E , Rolland , C , Samolinski , B , Sheikh , A , Toppila-Salmi , S , Tsiligianni , I , Valiulis , A , Valovirta , E , Vasankari , T , Ventura , M T , Walker , S , Williams , S , Akdis , C A , Annesi-Maesano , I , Arnavielhe , S , Basagana , X , Bateman , E , Bedbrook , A , Bennoor , K S , Benveniste , S , Bergmann , K C , Bialek , S , Billo , N , Bindslev-Jensen , C , Bjermer , L , Blain , H , Bonini , M , Bonniaud , P , Bouchard , J , Briedis , V , Brightling , C E , Brozek , J , Buhl , R , Buonaiuto , R , Canonica , G W , Cardona , V , Carriazo , A M , Carr , W , Cartier , C , Casale , T , Cecchi , L , Cepeda Sarabia , A M , Chkhartishvili , E , Chu , D K , Cingi , C , Colgan , E , De Sousa , J C , Courbis , A L , Custovic , A , Cvetkosvki , B , Damato , G , Da Silva , J , Dantas , C , Dokic , D , Dauvilliers , Y , Dedeu , A , De Feo , G , Devillier , P , Di Capua , S , Dykewickz , M , Dubakiene , R , Ebisawa , M , El-Gamal , Y , Eller , E , Emuzyte , R , Farrell , J , Fink-Wagner , A , Fiocchi , A , Fontaine , J F , Gemicioǧlu , B , Schmid-Grendelmeir , P , Gamkrelidze , A , Garcia-Aymerich , J , Gomez , M , Diaz , S G , Gotua , M , Guldemond , N A , Guzmán , M A , Hajjam , J , O'Hourihane , J B , Humbert , M , Iaccarino , G , Ierodiakonou , D , Ivancevich , J C , Joos , G , Jung , K S , Jutel , M , Kaidashev , I , Kalayci , O , Kardas , P , Keil , T , Khaitov , M , Khaltaev , N , Kleine-Tebbe , J , Kowalski , M L , Kritikos , V , Kull , I , Leonardini , L , Lieberman , P , Lipworth , B , Lodrup Carlsen , K C , Loureiro , C C , Louis , R , Mair , A , Marien , G , Mahboub , B , Malva , J , Manning , P , De Manuel Keenoy , E , Marshall , G D , Masjedi , M R , Maspero , J F , Mathieu-Dupas , E , Matricardi , P M , Melén , E , Melo-Gomes , E , Meltzer , E O , Mercier , J , Miculinic , N , Mihaltan , F , Milenkovic , B , Moda , G , Mogica-Martinez , M D , Mohammad , Y , Montefort , S , Monti , R , Morais-Almeida , M , Mösges , R , Münter , L , Muraro , A , Murray , R , Naclerio , R , Napoli , L , Namazova-Baranova , L , Neffen , H , Nekam , K , Neou , A , Novellino , E , Nyembue , D , O'Hehir , R , Ohta , K , Okubo , K , Onorato , G , Ouedraogo , S , Pali-Schöll , I , Palkonen , S , Panzner , P , Park , H S , Pépin , J L , Pereira , A M , Pfaar , O , Paulino , E , Phillips , J , Plavec , D , Popov , T A , Portejoie , F , Price , D , Prokopakis , E P , Pugin , B , Raciborski , F , Rajabian-Söderlund , R , Reitsma , S , Rodo , X , Romano , A , Rosario , N , Rottem , M , Ryan , D , Salimäki , J , Sanchez-Borges , M M , Sisul , J C , Solé , D , Somekh , D , Sooronbaev , T , Sova , M , Spranger , O , Stellato , C , Stelmach , R , Ulrik , C S , Thibaudon , M , To , T , Todo-Bom , A , Tomazic , P V , Valero , A A , Valenta , R , Valentin-Rostan , M , Van Der Kleij , R , Vandenplas , O , Vezzani , G , Viart , F , Viegi , G , Wallace , D , Wagenmann , M , Wang , D Y , Waserman , S , Wickman , M , Williams , D M , Wong , G , Wroczynski , P , Yiallouros , P K , Yorgancioglu , A , Yusuf , O M , Zar , H J , Zeng , S , Zernotti , M , Zhang , L , Zhong , N S & Zidarn , M 2019 , ' Next-generation ARIA care pathways for rhinitis and asthma : a model for multimorbid chronic diseases ' , Clinical and Translational Allergy , vol. 9 , 44 . https://doi.org/10.1186/s13601-019-0279-2
Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhi-nitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
In: Bousquet , J J , Schünemann , H J , Togias , A , Erhola , M , Hellings , P W , Zuberbier , T , Agache , I , Ansotegui , I J , Anto , J M , Bachert , C , Becker , S , Bedolla-Barajas , M , Bewick , M , Bosnic-Anticevich , S , Bosse , I , Boulet , L P , Bourrez , J M , Brusselle , G , Chavannes , N , Costa , E , Cruz , A A , Czarlewski , W , Fokkens , W J , Fonseca , J A , Gaga , M , Haahtela , T , Illario , M , Klimek , L , Kuna , P , Kvedariene , V , Le , L T T , Larenas-Linnemann , D , Laune , D , Lourenço , O M , Menditto , E , Mullol , J , Okamoto , Y , Papadopoulos , N , Pham-Thi , N , Picard , R , Pinnock , H , Roche , N , Roller-Wirnsberger , R E , Rolland , C , Samolinski , B , Sheikh , A , Toppila-Salmi , S , Tsiligianni , I , Valiulis , A , Valovirta , E , Vasankari , T , Ventura , M T , Walker , S , Williams , S , Akdis , C A , Annesi-Maesano , I , Arnavielhe , S , Basagana , X , Bateman , E , Bedbrook , A , Bennoor , K S , Benveniste , S , Bergmann , K C , Bialek , S , Billo , N , Bindslev-Jensen , C , Bjermer , L , Blain , H , Bonini , M , Bonniaud , P , Bouchard , J , Briedis , V , Brightling , C E , Brozek , J , Buhl , R , Buonaiuto , R , Canonica , G W , Cardona , V , Carriazo , A M , Carr , W , Cartier , C , Casale , T , Cecchi , L , Cepeda Sarabia , A M , Chkhartishvili , E , Chu , D K , Cingi , C , Colgan , E , De Sousa , J C , Courbis , A L , Custovic , A , Cvetkosvki , B , Damato , G , Da Silva , J , Dantas , C , Dokic , D , Dauvilliers , Y , Dedeu , A , De Feo , G , Devillier , P , Di Capua , S , Dykewickz , M , Dubakiene , R , Ebisawa , M , El-Gamal , Y , Eller , E , Emuzyte , R , Farrell , J , Fink-Wagner , A , Fiocchi , A , Fontaine , J F , Gemicioǧlu , B , Schmid-Grendelmeir , P , Gamkrelidze , A , Garcia-Aymerich , J , Gomez , M , Diaz , S G , Gotua , M , Guldemond , N A , Guzmán , M A , Hajjam , J , O'Hourihane , J B , Humbert , M , Iaccarino , G , Ierodiakonou , D , Ivancevich , J C , Joos , G , Jung , K S , Jutel , M , Kaidashev , I , Kalayci , O , Kardas , P , Keil , T , Khaitov , M , Khaltaev , N , Kleine-Tebbe , J , Kowalski , M L , Kritikos , V , Kull , I , Leonardini , L , Lieberman , P , Lipworth , B , Lodrup Carlsen , K C , Loureiro , C C , Louis , R , Mair , A , Marien , G , Mahboub , B , Malva , J , Manning , P , De Manuel Keenoy , E , Marshall , G D , Masjedi , M R , Maspero , J F , Mathieu-Dupas , E , Matricardi , P M , Melén , E , Melo-Gomes , E , Meltzer , E O , Mercier , J , Miculinic , N , Mihaltan , F , Milenkovic , B , Moda , G , Mogica-Martinez , M D , Mohammad , Y , Montefort , S , Monti , R , Morais-Almeida , M , Mösges , R , Münter , L , Muraro , A , Murray , R , Naclerio , R , Napoli , L , Namazova-Baranova , L , Neffen , H , Nekam , K , Neou , A , Novellino , E , Nyembue , D , O'Hehir , R , Ohta , K , Okubo , K , Onorato , G , Ouedraogo , S , Pali-Schöll , I , Palkonen , S , Panzner , P , Park , H S , Pépin , J L , Pereira , A M , Pfaar , O , Paulino , E , Phillips , J , Plavec , D , Popov , T A , Portejoie , F , Price , D , Prokopakis , E P , Pugin , B , Raciborski , F , Rajabian-Söderlund , R , Reitsma , S , Rodo , X , Romano , A , Rosario , N , Rottem , M , Ryan , D , Salimäki , J , Sanchez-Borges , M M , Sisul , J C , Solé , D , Somekh , D , Sooronbaev , T , Sova , M , Spranger , O , Stellato , C , Stelmach , R , Ulrik , C S , Thibaudon , M , To , T , Todo-Bom , A , Tomazic , P V , Valero , A A , Valenta , R , Valentin-Rostan , M , Van Der Kleij , R , Vandenplas , O , Vezzani , G , Viart , F , Viegi , G , Wallace , D , Wagenmann , M , Wang , D Y , Waserman , S , Wickman , M , Williams , D M , Wong , G , Wroczynski , P , Yiallouros , P K , Yorgancioglu , A , Yusuf , O M , Zar , H J , Zeng , S , Zernotti , M , Zhang , L , Zhong , N S , Zidarn , M , the ARIA Study Group & the MASK Study Group 2019 , ' Next-generation ARIA care pathways for rhinitis and asthma : A model for multimorbid chronic diseases ' , Clinical and Translational Allergy , vol. 9 , no. 1 , 44 . https://doi.org/10.1186/s13601-019-0279-2
Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhi-nitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
BACKGROUND: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. MAIN BODY: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. CONCLUSION: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
BACKGROUND: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. MAIN BODY: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. CONCLUSION: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
Anto, J M/0000-0002-4736-8529; Price, David/0000-0002-9728-9992; stelmach, rafael/0000-0002-5132-1934; J, Garcia-Aymerich/0000-0002-7097-4586; Rodo, Xavier/0000-0003-4843-6180; Barbara, C./0000-0003-0915-4105; Caimmi, Davide/0000-0003-4481-6194; Plavec, Davor/0000-0003-2020-8119; Briedis, Vitalis/0000-0002-5106-6638; Gemicioglu, Bilun/0000-0001-5953-4881; Fiocchi, Alessandro/0000-0002-2549-0523; Sova, Milan/0000-0002-8542-7841; Yusuf, M Osman/0000-0002-8067-1204; de Sousa, Jaime Correia/0000-0001-6459-7908; Pereira, Ana Margarida/0000-0002-5468-0932; Nadif, Rachel/0000-0003-4938-9339; Basagana, Xavier/0000-0002-8457-1489; Lourenco, Olga/0000-0002-8401-5976; Namazova-Baranova, Leyla/0000-0002-2209-7531; Humbert, Marc/0000-0003-0703-2892; Chavannes, Niels/0000-0002-8607-9199; N.G., Papadopoulos/0000-0002-4448-3468; Fonseca, Joao Almeida/0000-0002-0887-8796; Wong, Gary/0000-0001-5939-812X; Malva, Joao/0000-0002-5438-4447; Park, Hae-Sim/0000-0003-2614-0303; Cardona, Victoria/0000-0003-2197-9767; Pepin, Jean Louis/0000-0003-3832-2358; Popov, Todor/0000-0001-5052-5866; Ivancevich, Juan Carlos/0000-0001-8713-6258; VENTURA, Maria Teresa/0000-0002-2637-4583; Kuna, Piotr/0000-0003-2401-0070; orlando, valentina/0000-0002-8209-8878; Brusselle, Guy/0000-0001-7021-8505; Dauvilliers, yves/0000-0003-0683-6506; Zuberbier, Torsten/0000-0002-1466-8875; Panzner, Petr/0000-0002-1291-450X; van der Kleij, Rianne/0000-0002-8638-4978; yorgancioglu, arzu/0000-0002-4032-0944; Kaidashev, Igor/0000-0002-4708-0859; Custovic, Adnan/0000-0001-5218-7071; Chu, Derek/0000-0001-8269-4496; O'Hehir, Robyn/0000-0002-3489-7595; Costa, Elisio/0000-0003-1158-1480; Pugin, Benoit/0000-0001-7132-9477 ; WOS:000485072700001 ; PubMed ID: 31516692 ; Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement. ; POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health); ARIA; NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCESUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of General Medical Sciences (NIGMS) [P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334, P20GM121334] Funding Source: NIH RePORTER ; Partly funded by POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), and ARIA.
Numerous calls at national and international level are leading some countries to seek to redesign the provision of healthcare and services. Care pathways have the potential to improve outcomes by providing a mechanism to coordinate care and reduce fragmentation and ultimately costs. However, their implementation still shows variable results, resulting in them being considered as complex interventions in complex systems. By mobilizing an emerging approach combining action research and grounded theory methodology, we conducted a pilot project on care pathways. We used a strongly inductive process, to mobilize comparison and continuous theoretical sampling to produce theories. Forty-two interviews were conducted, and participant observations were made throughout the project, including 60 participant observations at meetings, workshops and field observations. The investigators kept logbooks and recorded field notes. Thematic analysis was used with an inductive approach. The present model explains the factors that positively or negatively influence the implementation of innovations in care pathways. The model represents interactions between facilitating factors, favourable conditions for the emergence of innovation adoption, implementation process enablers and challenges or barriers including those related specifically to the local context. What seems to be totally new is the embodiment of the mobilizing shared objective of active patient-partner participation in decision-making, data collection and analysis and solution building. This allows, in our opinion, to transcend professional perspectives for the benefit of patient-oriented results. Finally, the pilot project has created expectations in terms of spread and scaling. Future research on care pathway implementation should go further in the evaluation of the multifactorial impacts and develop a methodological framework of care pathway implementation, as the only existing proposition seems limited. Furthermore, from a social science perspective, it would be interesting to analyse the modes of social valuation of the different actors to understand what allows the transformation of collective action.
IntroductionTechnical solutions have been used in industry settings for many years to facilitate efficient management and analyses of big data sources. An initiative to apply a business solution to support development of simulation models for health systems research using nearly two decades of provincial administrative health data is described.
Objectives and ApproachAdministrative data including practitioner claims, hospitalizations and ambulatory care visits for patients with a diagnosis of osteoarthritis were obtained from Alberta Health for the period 1994/95 to 2012/13. These data were incorporated into a multidimensional data cube using Microsoft SQL Server Analysis Services. Initial steps required dimensional modeling to restructure the data into a star schema format. This involved appending several data sets and defining additional reference tables to contain stratification variables and denominator data for rate calculations. The modeling expert worked closely with the information technology team throughout the process and assessed validity of the output.
ResultsDevelopment and validation of the multidimensional cube occurred in iterations over approximately 12 months. The final solution resulted in an analytics platform that compiled data from approximately 400 million records obtained from four different administrative data sources. Ten dimension tables containing 102 variables provided enhanced flexibility to conduct ad hoc stratified analyses in a fraction of the time that would be required using conventional methods. For example, some analyses that previously required a day of analyst time could be performed in less than 15 minutes. The efficiencies in analytic time were achieved by the pre-aggregated measures and slice and dice capability of the data cube, which negated many intermediary steps for data extraction and time consuming iterative analyses required for development of the simulation models.
Conclusion/ImplicationsThis project demonstrated how a technical solution applied in industry can be utilized to address challenges encountered by researchers related to managing and analyzing large administrative health data sets. The methods could be applied in many other research settings to facilitate access to and analyses of information using big data.
In: Journal of policy and practice in intellectual disabilities: official journal of the International Association for the Scientific Study of Intellectual Disabilities, Band 11, Heft 1, S. 1-7
AbstractHealthcare pathways are a relatively new approach to delivering care in intellectual disability services. The authors endeavored to ascertain and explore successes and challenges in the implementation of care pathways in a National Health Service adult intellectual disability service in Leicestershire, UK. Data were obtained from a variety of sources including observations of multidisciplinary team meetings, issue logs, and feedback from health professionals. Constant comparative analysis identified 10 themes: communication between health professionals; clarity and dissemination of relevant documentation; multidisciplinary working; role of health professionals; role of administrative staff; locality differences; information technology systems; care pathway procedures; attitudes toward care pathways; and impact on clients. It was found that a new implementation of care pathways approach to service delivery in the healthcare setting can be challenging for health professionals. Some of the challenges were generic to service change and could be addressed through careful and organized preplanning of the implementation process. Others, such as organizational culture and attitudes within the organization, were contextual and may be unique to each service and warrant significant advance consideration when attempting implementation.
This comparative report on national care pathways for people with dementia living at home has been produced as part of the 2014 Work Plan of Alzheimer Europe, which has received funding from the European Union in the framework of the Health Programme. Decisions about the broad areas to be addressed were informed by a literature review on the topic. Agreement on the specific sections to be included for each area was reached in a meeting with 16 Alzheimer Europe (AE) member associations at the beginning of 2014. Based on this, a questionnaire was drafted and later reviewed by four members of the group. The final questionnaire was sent out to all AE members. In addition, in countries where AE has no member (i.e. Hungary, Latvia, Lithuania and Estonia), relevant informants were identified and invited to participate. 29 AE member associations and two external experts returned the questionnaires1. Questionnaires had been completed by the national organisation and, whenever necessary, with the aid of relevant national experts in the field of social policy, medicine and social support2. Organisations were contacted again when necessary to clarify certain issues and information was transferred into a database and analysed. The comparative report was sent to all participating organisations for final approval prior to publication. In addition to this comparative report, a national report for each country has been produced. These national reports are available to the public on the Alzheimer Europe website (http://www.alzheimer-europe.org). ; peer-reviewed
Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement. ; Peer reviewed
BackgroundIn all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main bodyAs an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care.ConclusionIn 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.