Identification of Barriers for Active Disease Management and of Medication-Related Problems through Therapeutic Patient Education in Older Home-Care Patients.

Combining therapeutic patient education (TPE) with a medication review service could foster the adoption of appropriate lifestyles by patients and support care-providers in identifying strategies to improve the quality of prescribed care. This study aimed to identify barriers experienced by patients in managing their diseases and medication-related problems. This was a monocentric, case series, observational study involving home-care patients from the Local Health Authority ASL TO4. Patients were enrolled for a TPE intervention where drug therapies and patient habits were collected through narrative interviews. Medication review was performed to identify potentially inappropriate prescriptions (PIPs). Twenty patients (13 females) with a mean age of 74.7 years were enrolled. Patients had an average of 4.3 diseases and 80.0% of them were treated with ≥5 daily medications. The main PIPs involved ibuprofen, furosemide and pantoprazole. The qualitative analysis of the interviews identified seven macro-themes relating to different aspects of medication management: therapy; diseases; patient; patient journey; professionals; family and caregivers; drug information. The results of this study revealed some critical aspects related to the treatment path and healthcare professionals. These results will be used to plan educational interventions for polypharmacy patients to improve medication adherence and the understanding and management of diseases.

[Applications of digital medicine to care pathways: taxonomy, methods, impact on patients, barriers to overcome.] / Applicazioni della digital medicine ai PDTA: tassonomia, metodologia, impatto sul paziente e barriere da superare.

Digital health represents an important step in the management of chronic diseases also in light of the reform of proximity care that is intended to be implemented as part of the Recovery Plan (PNRR). For this purpose, the inclusion of digital health tools in the care pathways is strategic. A specific Working Group of the MaCroScopio Project defined a taxonomic, methodological and cultural framework within which the development of digital health can be promoted. This would ensure that the introduction of this type of technological innovation addresses not only the need for a more efficient health system but also the real patients' healthcare requirements. At the same time it fosters the reduction of healthcare access inequalities, instead of their exacerbation.