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2 Specific Objectives Education and Empowerment Qualification of counselling for the empowerment of polymedicated patients Clara Cena 3.1 Improving decision making and adherence levels for polymedicated patients through patient empowerment, care team proactiveness and decision support systems Giuseppe Fico 3.2

3 Status: 2017 Activities 1. We have defined a pilot testing/proof-of-concept of an intervention to improve adherence, using Lessons learned from EIPonAHA A1 Group Madrid, West Midland, Stockholm Based on a Computerised decision support system (CDSS) for drug prescribing and drug utilisation reviews in Adapted from Swedish indicators to STOPP/START Criteria Integrated with EMR Linked to patient service and to expert support at distance Detailed analysis of quality of drug use Analysis of potential side effects

4 Status: 2017 Activities 1. We have defined a pilot testing/proof-of-concept of an intervention to improve adherence, using Lessons learned from EIPonAHA A1 Group Piemonte: identification of complex patients, defined as frail according to physical, psychologic and social aspects (Tilburg frailty index), with polytherapy and good candidate to a poor adherence model, at high risk of hospital admission for ADRs, at high expense. a Computerized Decision support system allows the implementation of the 3-R steps: reconnaissance of polytherapy (and of frailty determinants) revision of polytherapy reconciliation and education CDSS supports in particular the revision step, according to Beers criteria, STOPP/START criteria, ACB score, Micromedex classification of DDIs an Integrated Therapy Schedule (ITS) is available for patients: pictograms and short messages give essential information, intake instructions (e.g.: what I should do if I forget?)

5 Status: 2017 Activities 1. We have defined a pilot testing/proof-of-concept of an intervention to improve adherence, using Lessons learned from EIPonAHA A1 Group 2. First Interventions to be Piloted in Piemonte and Madrid Region Madrid - Based on a Computerised decision support system (CDSS) for drug prescribing and drug utilisation reviews in 1. Improving Drug Prescription in Primary Care 2. Improving Conciliation of Drugs between Primary and Secondary Care 3. Improving Drug Prescription of special risk patients in Primary and/or Hospital Care Piemonte ibidem Clinical Pharmacist collaboration is essential three scenarios: 3a: Nephrology ward- kidney transplantation Unit 3b: Home hospitalization project in geriatric ward 3c: Community-dwelling patients followed by GPs, with the collaboration of pharmacists working in local health units #ahacop18

6 2018 Activities 1. Intervention to be shared with other regions and partners: EIPonAHA - Reference Sites. Twinning between Campania (Community based) and Madrid (Interdisciplinary based). EIPonAHA - A1 and A3 Action Groups. Synergy between Evidence and Good Practice. EIT Health - Living Labs & Testbeds Reference Sites Towards Organizational Models for Reconciliation Piemonte Region, Campania Region, Coimbra, Stockholm, West Midlands, Others? #ahacop18

7 Intervention aimed at users education: 2017: to health professional within SUNFRAIL project and A3 AG a successful pilot experiment of intra-professional education 2018: to population with a pilot project of intragenerational education to the correct use of drugs and health products #ahacop18

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10 Thank you! #ahacop18