Given the ageing population and the related need for assistance, Emilia-Romagna Region is implementing strategies and interventions shifting from a passive-services’ approach to a pro-active community based approach. In this context, the Emilia-Romagna Region has adopted the following strategies:
- Development of a model of proactive care for people with frailty and multimorbidity using protocols of integrated care between clinical and primary care services also involving caregivers.
- Promotion of the assistance and health intervention based on intermediate structures, such as the Case della Salute (House of health), providing primary care service close to people place of residence, based on a pro-active community based care model (initiative medicine).
- Promotion of programs for the assistance and follow up of peoples with diseases related to frailty and multimorbidity.
- Implementation of programs of prevention through lifestyles involving young people: “Okkio alla salute” (8-9 years old) and the study “Health Behaviour in Schoolaged Children” (11-17 years old).
- Implementation of a National Surveillance programmes focussing on lifestyles involving adult and elders population: “PASSI” (18-69 years old), “PASSI d’Argento” (over 65).
Moreover, due to its wide range of good practices in the field of Ageing, Emilia-Romagna Region (through the RER-DG SPS and the ASSR-RER) is deeply committed in the field of Active and Healthy Ageing. Its involvement is reflected through the Regional Agenda and with the recent awarding of the EIP-AHA Reference Site status. The Region has committed to develop several research activities aimed at improving the capacity of the Regional System to address adequately elder’s preventive and curative care involving different stakeholders from the public, academic and private sector (call for projects in clinical governance research with 2.5 M. Euros budget).
Within the EIP on AHA context, the Emilia-Romagna Region is specifically committed on different actions brought about by 5 working groups: A1, A2, A3, B3 and C2. Through the initiative, the Region embraced the cause of promoting active and healthy ageing of its population in order to increase the quality of life in the elderly and, at the same time, to improve services sustainability.
As Lead Partner of the project, ASSR together with the Affiliated Entity Aster, has a long-lasting experience (almost twenty years) in the technical and financial management, administrative management and accounting supervision of EC funded projects as well as of national and international authorities (Ministry of Health, National Health Institute) funds.
The Regional Health Authority of Piedmont (RHAP) gained the role of Reference Site in the EIP-AHA in 2012. The RHAP can boast an experience of about 30 years in the regional government of healthcare services. The RHAP is responsible for the management and organization of healthcare in the Region, in strict cooperation with the Local Health Units and the Local Hospitals.
Since it became EIP-AHA Reference Site, the RHAP started to map and coordinate the several initiatives targeting older people on the regional territory. The RHAP started to connect interested stakeholders operating in the field, previously not connected, and strengthen existing traditional relations in the area, both institutional and informal ones.
The RHAP works in close cooperation with the local university, research institutes (IRES – Institute for Economic and Social Research) and healthcare staff training centres, so as to demonstrate a coverage of the relevant areas in the project. One of the added values of RHAP’s experience includes the cooperation with other regional health authorities in Italy, national and international bodies.
Liguria Region has developed during the years a wide range of policies addressed to this target of population, endeavouring to create a system including all the initiatives against isolation and in favour of prevention. Some services include:
- Active Ageing Project, to support NGOs cooperating with Social/Health Districts which implement prevention, socialization, permanent training
- Proximity services (Social Guardians) to observe and monitor frail elderly people and help them in the daily management
- Regional Fund “for not self-sufficiency” and Honour Loans with no interest rates for 36 months for people (mostly elderly) who need to pay refurbishment works of the flat, in absence of which they would be forced to leave their houses.
Campania is implementing a regional integrated model involving all relevant stakeholders to identify, validate and implement programmes to prevent and reduce functional decline and frailty among older people. Its objectives are raising awareness among professionals on relevant health care and cure innovations, screening of the population inside and outside clinical settings, evaluation of the effectiveness of innovative diagnostic tools and nutritional interventions. The final aim is implementing an integrated system of assessment, targeted interventions and services for active and healthy ageing based upon prevention of frailty and health equity.
Campania is actively involved in the EIP on AHA both as a Reference Site, and with multiple, coherent commitments, in the effort to exchange good practices with EU partners and scale them up to the benefit of older adults. Campania focuses on a lifestyle approach for preventing frailty, is and turn primary nutritional interventions into a powerful and sustainable tool for active and healthy aging, also exploiting opportunities of sociocultural involvement of older adults and enabling technologies as tools for societal innovation
CHRU MTP (and CARSAT LR) interact through MACVIA-LR. The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on Active and Healthy Ageing covering the 3 pillars of the EIP AHA. All sub-activities (A1: electronic pharmaceutical file, A2: falls prevention initiative, A3: frailty, B3: chronic respiratory diseases, chronic diseases with comorbidities, oral health and hepatitis virus C chronic infection, C2 and D4 active and independent living and handicap) are included in MACVIA-LR that has a strong political commitment and includes all stakeholders (public, private, patients, policy makers).
It is a Reference Site of EIP AHA build around chronic diseases, ageing and handicap. The framework of MACVIA-LR has the vision that the prevention and management against CDs is essential for AHA promotion and reduction of handicap.
The Department of Geriatrics of Medical University of Lodz was created in 2005. The Department provides hospital and ambulatory care for older patients and employs four physicians, two physiotherapists and four PhD students.
Main scientific and teaching activities include preventive geriatrics, physical disability, the role of muscle strength and power in maintaining independence in daily functioning, nutritional status and well-being in the elderly. Scientific activities include assessment of the patients (Comprehensive Geriatric Assessment), functional status, physical activity, nutritional status, rehabilitation and physiotherapy, nursing and social needs..
The long track of Deusto’s work in the field of Ageing has led to the establishment of an Interdisciplinary Research Platform on Ageing and Wellbeing. This Platform fosters the collaboration between the University and other important stakeholders, including local and regional authorities. This fruitful cross-sectoral cooperation has been evidenced by the European Commission’s recognition of the Basque Country as a Reference Site for innovation in active and healthy ageing.
The University of Deusto is a partner of the Reference Site which has been awarded three stars for an equal number of good practices. The Basque Reference Site consists of the following good practices:
- The Basque strategy for chronic conditions (Kronikgune)
- A pilot programme for person-centred care and case management (Etxean Ondo)
- The development of age-friendly environments (Biscay Provincial Government and University of Deusto).
DeustoTech-Life Research Group (eVida), a research group within the University of Deusto Engineering Faculty, is an experienced, dynamic and diverse team of telecommunications, electronics and software engineers, physicists, mathematicians and psychologists. Founded in 2002, the group is committed to research on and development of ICT-based tools, systems and interventions for psychological, social and physical health. Over the last decade, DeustoTech-Life has established close working relationships with key local stakeholders including hospitals, charities, other research groups and ICT companies.
DeustoTech-Life conduct applied research in two main areas. In the field of ICTs for Well-Being, DeustoTech-Life research, design, develop and test tools and systems which enable disabled people and the elderly to live more independent lives. DeustoTech-Life is currently involved in creating apps and devices for informal learning and informal learning follow-up services, programmes for person-centred care, and various tele-medicine and tele-monitoring systems. Work in this area has included applied research aimed at assisting groups such as people with intellectual disabilities, people with autism, people with visual impairments, people with hearing impairments, and people with multiple sclerosis. In the field of health, DeustoTech-Life specialise in creating diagnostic tools and systems and interventions for people with health problems such as skin and lung cancer, laryngectomy, epilepsy, migraines, dyslexia and bed sores. This work is based on long term research in the processing of: speech, ECG, EMG and EEG signals, and MRI (colon and lung cancer, articulatory description…), neuro fMRI, dermoscopy, pressure ulcers and stroboscopy images.
The Department of Health, Social Services and Public Safety (DHSSPS) is responsible for promoting an integrated system of health and social care designed to secure improvement in the: physical and mental health of people in NI; prevention, diagnosis and treatment of illness and the social wellbeing of people in NI.
Under the auspice of the DHSSPS, NI has been awarded three-star status for the EIP-AHA Reference Site. Innovation in medicines management, long term conditions management and implementation of Integrated Care Partnerships to enhance cohesion among health professionals involved in the care of older people have helped Northern Ireland achieve this world class recognition. Within the EIP on AHA context, NI has a number of commitments and is actively involved in 4 working groups:
- A1 – Prescription and adherence to Treatment,
- A3 – Prevention of functional decline and frailty
- B3 – Integrated Care; and
- C2 – Independent Living.
The Regional Health & Social Care Board (HSCB) and Regional Agency for Public Health and Social Well-being (PHA) are executive bodies of the DHSSPS. Working in partnership the HSCB and PHA develop an annual plan for the commissioning of services that are aligned with strategic aims and legislative direction set in place by the DHSSPS.
In NI there is a focus on providing community-based information, support and early interventions to allow people to manage long-term conditions and live independently (DHSSPS, 2012). More specifically there is a focus on frail older people in the “Transforming Your Care” strategic direction (DHSSPS, 2011) with six objectives:
- Manage functional decline and frailty through targeted intervention in physical fitness, nutrition status, cognitive function, chronic conditions and diseases, and on the social or psychological wellbeing of older people.
- Enhance the participation and independence of older people and their carers by empowering and enabling them to remain involved in meaningful activity and in a healthy lifestyle.
- Promote systematic routine screening for pre-frailty stages in at-risk patients and older people.
- Contribute to research and methodology on frailty and active and healthy ageing and contribute to knowledge generation concerning the mechanisms for ageing and the progression of frailty.
- Contribute to managing demand and increasing the sustainability of health and social care by reducing the personal, systemic and societal costs associated with ageing.
- Promote cooperation, including cross-sector international collaboration, between university research groups and companies dedicated to ageing issues in order to support competitive translational research and development.
EUREGHA is a network of 14 European Regional and Local Health Authorities focused on public health, which was created on January 30th 2006 according to an opinion of the Committee of the Regions’ regarding patient mobility and open coordination on health quality care. In addition to the 14 Full Members, EUREGHA has over 70 regions as Platform Members, a diverse and vast contacts’ database with which the network liaise on a regular basis.
It is the network of reference for regional and local authorities in health related issues and offers a wide range of services and opportunities of cooperation. EUREGHA aims to create synergies between regional and local authorities and EU stakeholders in the field of health issues with a very simple but important focus: Working together for more sustainable and efficient health care systems.
Further, EUREGHA functions as a portal to professionals working with prevention and management of frailty and care of multimorbidity in the EUREGHA member regions but that do not participate directly as partners to the project.
The Gérontopôle of the CHU-Toulouse is the only academic center in France specifically missioned by the French Ministry of Health and the Secretary of State for Older Adults to design, develop, and implement novel preventive and therapeutic strategies against disability in older persons. Such public acknowledgement is motivated by the fact that the Gérontopôle gathers together the required infrastructures, expertise, and clinical care facilities.
The Gérontopôle of Toulouse aims to federate research teams within a common structure in order to increase research activities and prevention initiatives to promote health improvements in older persons. This structure, unique in France, includes more than 400 healthcare professionals and integrates several facilities: the Pole de Gériatrie, the Institut du Vieillessement, and the Gérontopôle Research and Clinical Center. Moreover, the Gérontopôle has set in motion agreements with stakeholders all over the Midi-Pyrénées region (France), involving both clinical and research settings, and recruiting specifically trained clinical research personnel. This network composed by local and regional actors in the healthcare pathway for older persons allows over 30,000 older persons every year to benefit from clinical care and innovations from clinical research.
Several fields of expertise/research are present within the Gérontopôle, including geriatric medicine, Alzheimer’s disease (the Gérontopôle is the largest Alzheimer’s disease research and clinical center in France), nutrition, sarcopenia, and frailty (coordinating international scientific task forces on the topics). The Gérontopôle conducts clinical research and trials in all these domains, and coordinates large national and international studies. In particular (and in line with the objectives of SUNFRAIL), the Gérontopôle plays a key role of responsibility in a 5-year project on frailty and sarcopenia (Sarcopenia and Physical Frailty in Older People: Multi Component Treatment Strategies [SPRINTT]; www.mysprintt.eu), recently funded by the Innovative Medicines Initiative (overall budget 48 million euros).
Prof. Bruno Vellas, Head of the Gérontopôle, is past President of the International Association of Gerontology and Geriatrics (IAGG, a non-governmental organization recognized by the United Nations), President of the IAGG Global Aging Research Network (GARN), and founder of the European Alzheimer Disease Consortium (EADC, funded by the European Community).