Il Progetto Ipertensione negli Accordi Integrativi Locali fra FIMMG e AUSL di Ferrara: i risultati di un’esperienza
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The Hypertension Project in AIL (Local SupplementaryAgreements) between the Italian Federation of Family Doctors (FIMMG) and the Local Health Authority (AUSL) of Ferrara: results of an experience
Cardiovascular disease (CV) is the most common cause of death and permanent disability in industrialized countries and hypertension is among the most important CV risk factors. From 2001 to 2007, the Ferrara Local Health Authority (AUSL) in collaboration with the Italian Federation of Family Doctors (FIMMG) within the Local Supplementary Agreements (AIL), developed a working plan known as “Hypertension Project” aiming to improve the prescription appropriateness of antihypertensive drugs.
Materials and methods
An indicator measuring adherence of General Practitioners (GPs) to correct prescription of antihypertensive drugs was defined. The indicator was the Mean Cost of Defined Daily Dose (DDD) for antihypertensive drugs (MC-DDD-A) per GP, calculated as the total cost for antihypertensives during the time period considered divided by the total number of DDD of antihypertensives used in the same period.
Since 2003 expenditure for antihypertensive drugs has stabilized reaching an annual amount of €21,500,000.00, whereas from 2000 to 2002 the trend indicated an increase by €1,750,000.00 yearly. Actually, the MC-DDD-A of the Ferrara AUSL decreased from €0.54 in 2003 to €0.41 in 2007 compared to €0.50 and €0.46 of the Emilia Romagna Region. With regard to consequences on healthcare, in the same period (2003–2007) the DDD/1,000 persons/die of antihypertensive drugs decreased from 298 to 385 with a concomitant increase of DDD/1,000 persons/die of (less expensive) first choice antihypertensive drugs.
The “Hypertension Project” — which meets the principles of medical ethics and deontology — favoured greater adherence to the agreed objectives of appropriateness for the use of antihypertensive drugs and a more rational utilization of available resources, allowing a more extensive use of antihypertensive drugs without increasing healthcare expenditure.
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