Implementing proximity care for people with multiple sclerosis in Italy: the bottom-up approach of the StayHome project
Year: 2025
Type: article
Abstract: OBJECTIVE: In Italy, around 137,000 people live with multiple sclerosis, facing organizational complexities due to the current model's limited focus on proximity care. This project aims to define a proximity model, in accordance with recent developments in the Italian healthcare landscape, engaging over 150 healthcare stakeholders and potentially impacting approximately 14,000 patients. METHODS: An analysis was pursued to map the multiple sclerosis pathway, followed by interviews to capture the actual implementation in Italian Multiple Sclerosis Centers. Through the experts' insights, an optimal proximity care pathway and a Maturity Model framework were defined. This model was piloted in 14 centers, and a preliminary pre-post analysis was performed to evaluate initial improvements. Finally, a two-round Delphi method validated the Maturity Model dimensions and a set of key performance indicators. A scientific board including neurologists, patient associations and scientific associations, supervised project progresses and methodologies. RESULTS: The Pilot study results show an overall increase in the centers' positioning within the Maturity Model levels after adopting center-specific action plans. To generalize the model, the Delphi panel validated a subset of process, volume, outcome and patient experience indicators (9 of 26 proposed) along with qualitative dimensions defining the Maturity Model (13 of 20 proposed), therefore, outlining a comprehensive monitoring framework for the multiple sclerosis patient pathway. CONCLUSION: This study shows, for the first time in Italy, the efficacy of a bottom-up approach in addressing organizational challenges within the current multiple sclerosis scenario. This integrated model offers future opportunity for replication across various care pathways and settings.
Source: Journal of Neurology
Authors: M. Filippi, P. Gallo, C. Gasperini, G. A. Marfia, C. Avolio, R. Bergamaschi, M. Capobianco, M. Dotta, L. Grimaldi, G. Lus, F. Patti, E. Pucci, R. Quatrale, P. Solla, P. Bandiera, C. Angioletti, M. C. Gallottini, S. Parretti, L. Pinto, F. Pavone, S. Sanzone, the StayHome Project Working Group
Institutions: Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, University of Padua, Azienda Ospedale - Università Padova, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, University of Rome Tor Vergata, Policlinico Tor Vergata, University of Foggia, Fondazione Istituto Neurologico Nazionale Casimiro Mondino, Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo, Ospedale Michele e Pietro Ferrero - Verduno, Fondazione Istituto G. Giglio di Cefalù, University of Campania "Luigi Vanvitelli", Ospedale dell' Angelo, University of Sassari, Azienda Ospedaliero Universitaria di Sassari, Associazione Italiana Sclerosi Multipla, Biogen (Italy)
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
OpenAlex ID: W4406149414