13 August, 2015 – There’s a bit of Italy behind the European Implementation Score, which evaluates the differences in incidence, mortality and disability resulting from strokes, relating them to the different levels of research result implementation for the prevention and care of the disease in 10 countries (Belgium, France, Germany, England, Italy, Lithuania, Poland, Scotland, Spain and Sweden). The results of the study – whose WP2 was coordinated by Antonio Di Carlo of the Institute of Neuroscience of the National Research Council (CNR-In) and directed by Domenico Inzitari (CNR-In and University of Florence) – have been published the August issue of Stroke, the official magazine of the American Heart Association. “Studies generally show that up to 40% of patients do not receive care adequate to the latest scientific standards, with a substantial under-utilization of available interventions – explains Di Carlo – The results of our work package, in particular, indicate the best levels of integration between research and clinical practice, in order: England, Scotland, Sweden, France, Germany, Italy, Spain, Poland, Belgium and Lithuania. Countries with better overall quality of care are characterized by the presence of stroke units (units dedicated specifically to the assistance of stroke patients), national audits, as well as performance indicators and benchmarking structures.” Italy reaches medium to high scores “in five of the 11 analyzed indicators (national policies, educational strategies, activities of opinion leaders, complex interventions, and patient organizations), compared to 8 in Sweden, and 10 in England and Scotland. The major deficiencies in our country regard economic incentives, multi-professional collaboration, the use of computerized systems, the national audit and adoption of performance indicators. We registered better results at the regional level, where Italy reached medium to high scores in 8 of the 11 indicators analyzed, equal to those of Sweden and similar to those in England (9 of 11): However, there is a different level of implementation between regions in the North, Center and South. In the South, we registered a failure of regulatory actions, materials and information campaigns, and audit protocols for acute, medical and rehabilitation services.” The EIS was developed under the Seventh Framework Programme of the European Union, and is coordinated by Charles Wolfe, from King’s College London. “In all countries, however, the obstacles for implementation are organizational factors, lack of resources, bureaucracy, lack of knowledge of the disease, and resistance to change – concludes Di Carlo – The effective transfer of research results to clinical practice arises when it ranks among the most important objectives for politicians, administrators, professionals and patients. This is a necessary step if we want to provide a better service in Europe, especially when the restriction of resources is likely to hamper the application of evidence: not only scientific, but also organizational and welfare, such as, for example, those concerning the stroke unit in Italy in Decree 70 of 2 April 2015.” (Red)
