Improving the management of patients with chronic cardiac and respiratory diseases by extending pulse-oximeter uses: the dynamic pulse-oximetry.

Respiratory and cardio-vascular chronic diseases are among the most common noncommunicable diseases (NCDs) worldwide, accounting for a large portion of health-care costs in terms of mortality and disability. Their prevalence is expected to rise further in the coming years as the population ages. The current model of care for diagnosing and monitoring NCDs is out of date because it results in late medical interventions and/or an unfavourable cost-effectiveness balance based on reported symptoms and subsequent inpatient tests and treatments.

Standards of suitability for the management of chronic obstructive respiratory diseases.

Background: Chronic Obstructive Pulmonary Disease (COPD) ranks third as cause of mortality and disability-adjusted life years (DALY) worldwide and also in Italy it imposes a huge health, social and economic load. Early symptoms of COPD are often disregarded by patients and physicians, spirometry is underutilized, and the diagnosis is delayed till the disease has reached a distinct severity level. Despite the availability of various guidelines, the behavior of health workers involved in the management of COPD is still rather unlike.

AIMAR survey on complex forms of bronchial asthma and COPD, their management and perception of critical issues.

Background: The management of patients with complex forms of bronchial asthma and COPD is not usually addressed in the major international guidelines and management documents which exclusively address pure forms. AIMAR thus undertook a survey to obtain information about: a) the perceived frequency of complex forms of asthma/COPD in adult patients and in the elderly; b) patient management regarding the complex forms (focus on therapeutic goals and consequent treatment); c) the management problems perceived in diagnosis, management, monitoring, indices of appropriateness in pharmacological treatment and adherence to treatment.

Methods: The survey consisted of 18 multiple choice questions, completed by means of a web-based electronic form published in internet.

Audit on the appropriateness of integrated COPD management: the "ALT-BPCO" project.

Background: Non communicable chronic diseases (including respiratory ones) are the leading cause of death and disability. To cope with them we need to redesign the health system, improving primary prevention, screening, and outpatient services, while fully integrating different branches of the health service. The Italian Ministry of Health published extended guidelines on integrated COPD management (COPD-GL) in 2010.

Pneumocafé project: an inquiry on current COPD diagnosis and management among General Practitioners in Italy through a novel tool for professional education.

Background: Symptoms of COPD are frequently disregarded by patients and also by general practitioners (GPs) in early stages of the disease, that consequently is diagnosed when already at an advanced grade of severity. Underdiagnosis and undertreatment of COPD and scarce use of spirometry are widely recurrent, while a better knowledge of the disease and a wider use of spirometry would be critical to diagnose more patients still neglected, do it at an earlier stage and properly treat established COPD. The aim of Pneumocafè project is to improve, through an innovative approach, the diagnosis and management of COPD at primary care level increasing the awareness of issues pertaining to early diagnosis, adequate prevention and correct treatment of the disease.

AIMAR survey on COPD phenotypes.

Background: COPD is characterized by considerable diversity in terms of clinical signs and symptoms, physiopathological mechanisms, response to treatment and disease progression. For this reason, the identification of different patient subgroups (or possible phenotypes) is important both for prognosis and for therapeutic objectives. Based on the foregoing, AIMAR has decided to conduct a survey on the perception of the prevalence of the different clinical COPD phenotypes/subtypes in the clinical practice of physicians who treat patients with chronic obstructive pulmonary disease, and on their therapeutic objectives.

He@lthCo-op: a web-based system to support distributed healthcare co-operative work.

Healthcare is characterized by close collaboration and information sharing among many distinct actors, who co-operate for the patient care in different temporal moments, also at a distance. In this context, availability to care givers of all relevant patient health data and of specific healthcare co-operative work supporting tools is fundamental for best patient treatment. We designed and implemented He@lthCo-op, a web-based modular system supporting co-operative work and patient information secure sharing among healthcare personnel also from remotely located sites.