Disease Management is the concept of reducing healthcare costs and/or improving quality of life for individuals with chronic disease conditions by preventing or minimizing the effects of a disease, or chronic condition through integrative care. Disease Management is concerned with care of common chronic illnesses, and the reduction of complications associated with those diseases. Disease Management involves different health professionals and administrators within all areas of the health system, who share a common vision and collaborate on coordinated initiatives. They together support health service delivery to patients living with long-term and life-threatening illnesses, and assist them by developing treatment strategies for diseases often associated to other pathologies and poly-pharmacy. By applying the concepts of Disease Management it is possible to contrast discontinuation of therapies or deviation from guidelines and to support appropriateness in a health system that is increasingly facing economical constraints. Thus, clinical and economical plans, that ultimately involve political and ethical issues, are the prerequisite for an efficient Disease Management program. In this scenario, the role of drugs must be reconsidered. Clinical trials define safety and efficacy of novel medicines, but the identification of their effectiveness in clinical practice, when patients are exposed to drugs under variable clinical, social, cultural and economical conditions, is required. Specific outcome research studies are urgently needed to address these issues for many drugs and therapeutic regimens. An accurate methodology has to be refined to obtain high quality data on safety and effectiveness, that must be used for an updated evidence-based medicine. A selected panel of international leading authorities in the field of pharmaco-utilization, -epidemiology, -vigilance and -economics will discuss the role of their specific disciplines in the management of chronic diseases in the aging population. Great expectation for the goal of a personalized therapy is based on pharmacogenetics. The introductory lecture and other presentations during the meeting, will be dedicated to this innovative subject in the setting of clinical practice. The last edition of The Goodman and Gilman’s Pharmacological Basis of Therapeutics reads that non-compliance with prescribed therapies is the main reason for treatment failure particularly in chronic disease. We deeply hope that the present meeting may increase the awareness of pharmacologists, clinical investigators, and general practitioners on appropriateness in the use of medicines for a better management of chronic diseases.
Pierangelo Geppetti and Alessandro Mugelli