Thomas Jefferson University
Sidney Kimmel Medical College
Asano-Gonnella Center for Research in Medical Education & Health Care

Current Projects: Parma Local Health Authority Projects

Building on our work with the regional health care system of Emilia-Romagna and the database and analytical methods previously developed, the team at Thomas Jefferson University has been collaborating on a series of analyses for the Local Health Authorities of Parma and of Reggio Emilia that use population-based methods to provide information useful to the hospitals, the health districts, and the physicians practicing in these areas in their ongoing efforts to improve the quality and efficiency of care provided to their populations. Projects include studies of the integration of hospital and outpatient care and analyses of patterns and appropriateness of pharmaceutical care.

Appropriateness of Prescribing for the Elderly

Funded by the Parma Local Health Authority, we have designed, developed and implemented a multi-year project aimed at improving the appropriateness of medication prescribing for the elderly patients. This project has led in 2007 to the development with the help of a panel of experts of the first Italian explicit list of potentially inappropriate medications known in the literature as the Maio criteria. The Maio criteria have been updated three times, in 2011, in 2014, and in 2017. We used the 2014 Maio criteria in a study recently published in the British Journal of Clinical Pharmacology to assess the impact on hospitalization rates of the use of potentially inappropriate medications in a large population-based cohort of older adults.

Deprescribing Unnecessary Medications

At the request of the Parma Local Health Authority, we are working on a project targeting primary care physicians to develop training/information tools to promote and support medication deprescribing. Primary care physicians have been surveyed to evaluate confidence towards deprescribing and related perceived barriers. Results of this study have been recently published in the Journal of Clinical Pharmacy and Therapeutics.

Identification of High Risk Patients in the Pediatric Population

Funded by the Parma Local Health Authority, we have developed and tested predictive models to identify high-risk patients in the pediatric population. Details of these models, which perform sufficiently well, have recently been published in BMJ Open. Profiles of high-risk children are being provided to pediatricians and other health care professionals involved in care for this population.

Evaluation of the Impact of Medical Homes

At the request of the Parma Local Health Authority, we have begun to investigate the impact of newly established Medical Homes. Preliminary results of this study have been recently presented at the 23rd International Society for Pharmacoeconomics and Outcomes Research Annual International Meeting.