EMPOWERING HOSPITAL. Promoting healthy lifestyles for improving the quality of life of people suffering from chronic diseases

Size: px

Start display at page:

Download "EMPOWERING HOSPITAL. Promoting healthy lifestyles for improving the quality of life of people suffering from chronic diseases"

Marian Briggs
5 years ago
Views:

1 The Emp-H Consortium is composed by 5 partners from 4 different Eu Countries (Italy, Spain, Ireland and Lithuania): Local Health Authority of Biella (ASL BI) Italy (LEAD PARTNER) Lithuanian Multiple Sclerosis Union (LISS) - Lithuania Fundacion para la Investigacion del Hospital Universitario la Fe de Valencia (HULAFE) - Spain Università del Piemonte Orientale (UPO) - ItalyDublin City University (DCU) Ireland AZIENDA SANITARIA DI BIELLA (ITALY) Via dei Ponderanesi 2 Ponderano/Biella Project emph.progetto@aslbi.piemionte.it Emp-H Project (n ) has received funding from the European Union s Health Programme ( ) EMPOWERING HOSPITAL 1 May 2015/30 April 2018 Promoting healthy lifestyles for improving the quality of life of people suffering from chronic diseases

2 THE CONSORTIUM The Local Health Authority of Biella (ASL BI) operates on the territory of the Province of Biella in Piedmont, a region in northgeneral hospital western Italy. The ASL of Biella comprises a ('Ospedale degli Infermi') and handles all aspects regarding health in their catchment area, which comprises about residents and is divided into 73 municipalities. A new hospital with 450 beds was recently built and open in Autumn ASL BI mission consists in achieving the following health objectives for its catchment area: to promote health; to prevent diseases and unhealthy conditions; to treat diseases and unhealthy conditions; to reduce harm and functional damage resulting from diseases and to maintain the highest level of independencee and quality of life. The hospitalization rate in Italy has reduced in recent years, which reflects the constant attention paid to increasing appropriateness. Simultaneously, in the area of Biella fewer and fewer subjects choose to treat authorities than the ASL of Biella, whilst the number of hospital admissions remained substantially constant. The constant growth of outpatients treated at the hospital of Biella consolidates the apparent good liaison between the community and the hospital. ASL BI is associated with the Health Promoting Hospitals (HPH) Network. ASL BI: HULAFE is a non-profit organization that oversees and manages the scientific policy of the Health Department La Fe in Valencia. The Health Department Valencia - La Fe is one of the health provision areas belonging to the Health Care System of the Region of Valencia (Spain), under the umbrella of the Valencia Health Agency. This Health Department covers a concrete geographical area located in the city of Valencia and coordinates all the healthcare services provided in the territory, from primary to tertiary care, covering inhabitants directly and a catchment area adding up to persons. Hospital La Fe is well-known in Spain as a leading hospital in the management of several diseases, in the provision of home hospitalization services and in pursuing of the integration of all the care levels for the comprehensive case management of chronic patients. HULAFE has already participated in several national and European projects regarding chronic disease management, reengineering of healthcare processes, home monitoring and deployment of clinical pathways. EMP-H Project has been led by erpss research team that is an interdisciplinary research team between two of the major research entities of the region of Valencia: the Technical University (UPVLC) and the Research Foundation of the Hospital La Fe, which aims to consolidate multidisciplinary research that combines studies in clinical, technical, technological, social, welfare, organizational and market projection aspects. Furthermore the group is part of the Reference Sites of the European Partnership Initiative in Active and Healthy Ageing (EIP-AHA) awarded with 3 excellence stars by the European Commission. HULAFE:

3 The Università del Piemonte Orientale (in short, UPO) is a young and dynamic university located in Novara, Italy, at a short distance from both Milan and Torino. Established in 1998, UPO has created an extensive network that includes many top universities and world- as the second famous research centres. In 2013, UPO has been ranked best Italian University for biomedical research, and as the first among state-run Medical Schools (VIA-Academy, 2013). UPO has considerable experience in presenting and managing European research projects. The Public Health Unit coordinated by prof. Faggiano is based at UPO's Department of Translational Medicine. The Department has extensive knowledge and expertise in the field of prevention of risky behaviours in adolescents, evaluation of prevention interventions, implementation of evidence-based interventions, research on mediating variables for risky behaviours, systematic reviews, and evaluation of clinicall studies. The group has experience working on 4 large national and international randomized controlled trials aiming to evaluate the effectiveness of 4 diverse prevention interventions. The group collaborates with internationals partners such as Karolinska Institutet, Oxford Brookes University, King's College London, UNICEF, UNODC, and the EMCDDA. The group has specific experience on training, implementation and dissemination of Unplugged, a European prevention intervention which was found effective in tackling substance use and abuse in adolescence and was disseminated in Central-Eastern Europe, and in Egypt, Lebanon, Jordan, UAE, Morocco, Kuwait. Over the last few years, the group has been involved in several European projects, namely Alice Rap, Eu-Dap, SPAN, EMDAS, Smoking in movies, TEENAGE. It collaborates with the Ministry of Health and with the National Agency for Health Services. Dublin City University has been consistently ranked among the best 100 young universities in the world. DCU has community engagement as strategic priority and a strong vocation to translate healthcare innovation into benefits to the society. The Faculty of Science and Health at Dublin City University is a unique cluster of Research Centres and Teaching Schools focusing on preventing or delaying the morbidity and mortality associated with chronic diseases prevalent in the European Union. In particular, the School of Health and Human Performance and the School of Nursing and Human Sciences aim to develop novel and effective physiological and behavioural interventions to be implemented in clinical care facilities and to be delivered as community-based prevention programmes. DCU researchers have been successful in securing grants to undertake basic and applied research projects from several agencies including EU- FP7, Science Foundation Ireland, Health Research Board, Enterprise Ireland, Irish Heart Foundation. UPO: Dublin City University DCU:

COLLABORATING PARTNERS HPH Network Health Promoting Hospitals Copenaghen (DK) Regione Piemonte Piedmont Authority Torino (I) Lithuanian Multiple Sclerosis Union (LMSU), is a member of the European MS

LILT Biella Lega Italiana per la Lotta contro I Tumori Sezione di Biella (I) Fondazione Edo ed Elvo Tempia - Biella (I) Lithuanian Multiple Sclerosis Union is the only national organisation providing

4 COLLABORATING PARTNERS HPH Network Health Promoting Hospitals Copenaghen (DK) Regione Piemonte Piedmont Authority Torino (I) Lithuanian Multiple Sclerosis Union (LMSU), is a member of the European MS Platform, European MS Federation and member of Eurocarer association. The Organisation also is one of the initiator in the founding of the Baltic MS Alliance. LILT Biella Lega Italiana per la Lotta contro I Tumori Sezione di Biella (I) Fondazione Edo ed Elvo Tempia - Biella (I) Lithuanian Multiple Sclerosis Union is the only national organisation providing information, support and advocacy services to the MS community. Organisation work with people with MS, their families and carers and a range of key stakeholders including health professionals, students and other interested in or concerned about MS to ensure that meet their goals. A range of living with MS programmes, workshops and activities are organised throughout the country that are targeted at various groups such as those newly diagnosed, carers, children of parents with MS and health professionals. Programmes include physical therapies, symptom management and information/education seminars. LMSU has established 16 local societies in the through the Lithuanian territory, closely works with 5 hospitals, where multiple sclerosis centres are developed. In the LMSU through time to time are working from 10 to 15 staff and volunteers, who are support network for people and families living with MS in local communities. They provide a welfare service, access to various therapies and organise various social gatherings. who help in the different events and trainings. Lithuanian Multiple Sclerosis Union (LMSU):

5 THE PROJECT Empowering Hospital is a multicentre project aims to foster health promotion interventions and environments suitable for prevention of chronic diseases. The strategy is based on the Health Promoting Hospitals (HPH) framework with a strong emphasis on evidence-based prevention. Through its activities the project aims to promote the adoption of healthy lifestyles for improving the quality of life of people suffering from a chronic diseases, particularly those diagnosed with diabetes, cardiovascular disease, breast, colorectal or prostatic cancer and other major chronic diseases. Chronic patients, relatives and hospital staff (about subjects overall) were plan to be selected to receive an intensive counseling session aimed to design and plan a tailored preventive pathway according to the behavioral risks factors identified with a profiling tool (a questionnaire, elaborated during the first year of the project, based on 4 risks factors: smoking, alcohol consumptions, sedentary behavior and, unhealthy diet) based on literature review of evidence-based interventions. The introduction of a health promoting model in hospital setting offers people suffering from chronic diseases, their relatives and health workers a new way for adopting healthy lifestyles. Moreover, Empowering Hospital project supports people to organize their daily activities in a healthier way thus improving quality of life and reducing potential costs of further hospital admissions, outpatient visits, etc. It contributes and safeguards the sustainability of the local health and social systems. Intervention providers (health professionals and hospital volunteers) received specific training sessions at each pilot site through a homogenous health promoting approach: basic distance learning activities accessible from the project website in 3 different languages (Italian, Spanish and English) and residential training course. For this purpose a set of tools and materials were developed, including informational support for the training modules, literature reviews and clinical guidelines. An extraction of these materials have been published in the project website ( In order to evaluate the effect of the Emp-H project developed a randomized controlled trial (RCT). For this purpose, subjects divided in three groups (patients, patients caregivers/relatives, and hospital workers) were rendomised to receive two interventions. The first intervention (control) consists in risk profilation, brief advice and informative materials delivery, while the second (intervention) added at this basic approach, an intensive counselling and the access to hospital and community supportive resources. All the participants beneficiated of the ongoing hospital environmental change (smoking policy, new walking paths, reorganization of the hospital canteen, etc.). Participants to be included in the study had to present almost one risk factor and be aged between 40 and 75. Primary outcomes and cut-off value to be considered at risk were: smoking, poor nutrition (<5 port/day fruit and vegetables, >1 sugary drink/day), physical inactivity (less than 150 min moderate PA/week and/or 75 min vigorous PA/week), alcohol consumption (>1/2 glasses/day and >1 monthly binge drinking), and BMI (>25). All the participants were followed for 6 months, at the end of which received a phone survey.

6 The study was able to verify the effectiveness of the Emp-H in modifying all the targetted risky behaviours. In particular it was demonstrated a greater effectiveness of the studied intervention on the reduction of risky alcohol behaviours and the increase in physical activity intensity, compared to the control conditions. A further evaluation of the resources spent to deliver the intervention was able to inform hospital managers about the sustainability of the Emp-H model. All the participant were recruited in the following area: Cardiology, Diabetology, Dietetics, Oncology, Occupational risk, Pneumology, and GP surgeries. In the three territories (Biella, Valencia and Vilnus) a considerable effort was made to: - map resources and networks, - strengthen the already existing and consolidated territorial network, - formalize new agreements. OFFICIAL FINAL VIDEO The official and final Emp-H video, created together by all members of the project, shows an overview of people, faces, staffs, volunteers and concerned catchments, involved for 3 years in Lithuania, Italy and Spain. Emp-H Project (n ) has received funding from the European Union s Health Programme ( ) The video is available on EMP-H website, or at:

7 Final Conference was held, in Biella on March 20, 2018 were all results were presented an final video was showed. THE MAIN RESULTS The impact of the intervention on lifestyles Here you can find the: Slides of the guest speakers: Video message of Vytenis Andriukaitis, European Commissioner for Health and Food Safety (EU): Description Proportion of subjects profiled out of at-risk subjects Proportion of subjects participating to counselling out of profiled subjects Proportion of subjects willing to change their risk factor, out of those receiving counselling (intention within the next month) Proportion of subjects modifying their risk factor by adopting behavioural change, out of those receiving counselling (behaviours) (% improvement in the respective categories). Achieved Outcomes 90 % 73,6% 12% smokers; 3.3% excessive alcohol consumers; 11.1% insufficient fruit&vegetables consumers; 7.73% inactive people 2.46% of insufficient fruit&vegetables consumers reaches the recommended consume; 50% of excessive sugary drinks consumers reaches the recommended consume; 12.33% of smokers quit; 58.97% of excessive alcohol consumers reaches the recommended consume; 82.86% of monthly binge drinkers reaches the recommended consume; % of inactive people reaches the recommended level of physical activity

8 EMP-H HANDBOOK/MANUAL Handbook on how to implement healthy lifestyles promoting activities A milestone of the EMP-H project is the Manual for health professionals and hospital managers on how to implement a healthy lifestyle empowerment service. This manual has been presented during the Final Conference of the project, held in Biella in March This manual offers practical information on how introduce healthy lifestyles promotion practices in the hospital setting in other EU countries and regions. The handbook summarizes the best evidence-based behavioral change practices towards healthy lifestyles. The central chapters of the manual are on how to implement a sustainable education to empowerment service within the hospital targeting healthcare professionals, patients and their relatives. Finally, the handbook provide guidance on how to integrate services offered within the hospital and in the catchment area / health service jurisdiction. The manual is available on the project website This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein. The added value of the project is represented by the attention paid to individual and collective empowerment, introduced in the clinical activity. FOUR QUESTIONS ABOUT THE PROJECT What is the purpose of the EMP -H project? The EMP-H project proposes a sustainable and replicable method to promote the adoption of healthy lifestyles. The EMP-H project is aimed at citizens who suffer from chronic-degenerative diseases to improve their quality of life. The project helps patients to change lifestyles to prevent complications and sharpening: no smoke, no alcohol, eating healthy foods, no sedentary lifestyle What are the benefits from the EMP-H project? Provide a practical help to improve the quality of life and reduce the risk factors that arise from incorrect lifestyles. Provide information and support to healthcare professionals and create social environments conducive to change lifestyles. How did we help the EU citizens? - introducing activities to promote healthy lifestyles in hospitals that normally deal with therapy and not prevention, exploiting "teachable moments" - involving healthcare professionals to use effective counseling techniques - adopting an evidence-based approach to evaluate an organizational model to promote healthy habits in hospital What are the results? The results of the trial are positive and show that the model can be applied in daily practice. People who have used the services promoted by the EMP-H project made progress towards adopting healthy lifestyles, more inclined to physical activity, but also to reduce the other risk factors: smoke, alcohol, unhealthy foods

WHO Secretariat Dr Shanthi Mendis Coordinator, Chronic Diseases Prevention and Management Department of Chronic Diseases and Health Promotion World

WHO Secretariat Dr Shanthi Mendis Coordinator, Chronic Diseases Prevention and Management Department of Chronic Diseases and Health Promotion World Health Organization 'Zero Draft' Global NCD Action Plan