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CHRODIS-PLUS: Implementing good practices for chronic diseases [CHRODIS-PLUS] [761307] - Joint Actions
Project abstract

Europe is paying a heavy price for chronic diseases (CD): it has been estimated that CD cost EU economies 115 billion € or 0.8% of GDP annually; and this figure does not include the additional loss in terms of lower employment rates and productivity of people living with chronic health problems. However, the aspiration is a health-promoting Europe, free of preventable CD, premature death and avoidable disability could be possible. Initiatives on CD should build on four cornerstones: health promotion and primary prevention as a way to reduce the burden of CD; patient empowerment; tackling functional decline and quality of life as the main consequences of CD, and making health systems sustainable and responsive to the aging of our populations associated with the epidemiological transition (an increase in incidence of CD and extended life expectancy) whose consequence is an increasing prevalence of CD. In this Joint Action, CHRODIS-PLUS, our goal is to support Member States through cross-national initiatives identified in JA-CHRODIS to reduce the burden of CD, while assuring health systems sustainability and responsiveness. CHRODIS-PLUS aims to promote the implementation of policies and practices with demonstrated success in each of the four cornerstones mentioned, in closely monitored implementation experiences that can be validated before scaling them up. For this, a total of 42 beneficiaries representing 20 European countries will collaborate to implement pilots and generate practical lessons that could contribute to the uptake and use of CHRODIS-PLUS results. Practices to be implemented will be based on the collection of policies, strategies and interventions that started in JA-CHRODIS and in its outputs such as the Integrated Multimorbidity Care Model or the Recommendations for Diabetes Quality criteria or national plans. During the 36-month life CHRODIS-PLUS will disseminate its activities and monitor and evaluate them to verify the progress and impact of the action. CHRODIS-PLUS will look for synergies with international/regional/local policy initiatives in CD. CHRODIS-PLUS will count on the Governing Board of representatives from European Ministries of Health, key to CHRODIS-PLUS development and sustainability, an Executive Board and a General Assembly where all associated partners will gather. A proposal for the EU added value of cross-country collaboration in the field of CD and the sustainability of the results from JA-CHRODIS and CHRODIS-PLUS beyond 2020, when this project ends, will be approved.

Summary of context, overal objectives, strategic, relevance and contribution of the action

Europe is paying a heavy price for chronic diseases (CD): it has been estimated that CD cost EU economies 115 billion € or 0.8% of GDP annually; and this figure does not include the additional loss in terms of lower employment rates and productivity of people living with chronic health problems. However, the aspiration is a health-promoting Europe, free of preventable CD, premature death and avoidable disability could be possible; thee already countries that have been showing steep improvements in indicators related with CD control, providing therefore with opportunities for other counties to learn from their success. Initiatives on CD should build on four cornerstones: health promotion and primary prevention as a way to reduce the burden of CD; patient empowerment; tackling functional decline and quality of life as the main consequences of CD, and making health systems sustainable and responsive to the aging of our populations associated with the epidemiological transition (an increase in incidence of CD and extended life expectancy) whose consequence is an increasing prevalence of CD.

In this context surrounds the CHRODIS+ Joint Action, that is a three-year initiative (2017-2020) funded by the European Commission and the participating organizations, that involving a total of 42 beneficiaries representing 20 European countries. The overarching goal of CHRODIS+ is to support Member States through cross-national initiatives identified in JA-CHRODIS to reduce the burden of CD, increase the sustainability of health systems and develop human capital. The focus will be on tangible trans-national activities with a potential to trigger health and CD policies in Member States with the prospective to improve health outcomes. In specific terms, the aim of CHRODIS+ is to promote the implementation in several countries of innovative policies and practices for patient empowerment, health promotion and prevention, and fostering quality management of CD and multimorbidity as well as for improving the adaptation of the employment sector to chronic patients, in pilot actions that can be validated before scaling them up.

Innovative practices will be identified based on the collection of policies, strategies and interventions that started in JA-CHRODIS and in its outputs such as the Integrated MultiMorbidity Care Model or the Recommendations for Diabetes Quality criteria or national plans. They will be also based on other outputs derived from projects such as the EU PATHWAYS project on CD and the employment strategies in Europe. The cross-national implementation of these innovative practices will be promoted by CHRODIS+ supporting the cross-national collaboration of local implementers and maximizing the dissemination of the lessons learnt through a clear strategy engaging the appropriate stakeholders, promoting the integration and sustainability of the novel, inter-sectorial approaches to health promotion and disease prevention and CD care into national policies. Policy Dialogues will be conducted in several countries (15 countries) and at the EU level (2) with the ultimate aim to provide a proposal of tangible actions in order to have country specific impact for better management of CD. The Policy Dialogues will result in guidance for health sector stakeholders to achieve policy impact. CHRODIS+ will also establish operational links with existing European strategies (at international-national-local levels).

In relation to strategic relevance and contribution of this health programme, the CHRODIS+ addresses the Action on CD co-financed with Member States authorities of the Work Programme of 2016 and is aligned with the WHO-EURO and its policy initiatives on CD. The specifications of this Work Programme 2016 refer to the thematic areas, working method and expected impact.

Thematic areas: CHRODIS+ will support Member States to promote the implementation of innovative evidence based policies and practices on empowerment, health promotion,

Methods and means

CHRODIS+ combine the selection of best suited good practices or recommended interventions with the support given to policy makers and organisations for the long term sustainability them. These organisations and policy makers may be operating at national, regional or local level. The practices or interventions will fit their needs. This JA includes the following 8 work packages:

- WP1: Coordination
- WP2: Dissemination
- WP3: Evaluation
- WP4: Integration in national policies and sustainability
- WP5: Health promotion and disease prevention
- WP6: Pilot Implementation of Integrated Care Model for multimorbidity
- WP7: Fostering quality of care for people with chronic diseases
- WP8: Employment and chronic diseases: health in all sector

This JA has defined 3 specific objectives that will be achieved by the following methods and means:

-In close collaboration with the Coordinator and under the supervision of the Scientific Coordinator, the 3 WPs with pilots (5, 6 and 7) have a first preparatory task, which will elaborate a common cross-WP perspective, as all 3 will have the participation of the same partner in this phase, KRONIKGUNE, with the purpose to guaranteeing that the process of work, although adapted to the specifics of the 3 WPs, shares common principles. Expert advice for developing the implementations will be organized through EC/ DG SANTE, if required. Pilots will be implemented and the JA will then analyse interventions that can be transferred from good practices identified across Europe (in particular those already identified during JA-CHRODIS), or those recommended by evidence based guidelines, that are of a scope that can be managed in the frame of this JA, and that are approved by the implementing organisations. The inter-sectorial relationship of the employment sector and workers with CD will be explored from two perspectives: as a place for preventing the onset chronic conditions and as a place where people with chronic conditions work.

- CHRODIS+ will look for synergies with international/regional/local policy initiatives in CD. A proposal for the EU added value of cross-country collaboration in the field of CD and the sustainability of the results from JA-CHRODIS and CHRODIS+ beyond 2020, when this project ends, will be approved.

- The CHRODIS Platform, as part of WP2, will continue with its work in the collection of good practices initiated in JA-CHRODIS until is transferred to the Commission. A dissemination strategy will maximize the impact of CHRODIS+ outputs and Evaluation and Monitoring Plan (WP3) will assess the advancement of the JA and propose corrections when necessary. A Stakeholder Engagement process will guarantee their participation.

The following pilot implementations will be conducted:

- Health promotion & primary prevention: 8 pilots in Iceland, Italy, Lithuania, Malta, Spain,
- Integrated Multimorbidity Care Model: 5 pilots in Italy, Lithuania, Spain
- Fostering quality of care for people with CD: 5 pilots in Croatia, Finland, Greece, Serbia, Slovenia
- ICT based patient empowerment: 3 pilots in Bulgaria, Germany, Spain
- Employment & chronic diseases: 1 pilots in Finland

Details
Start date: 01/09/2017
End date: 31/08/2020
Duration: 36 month(s)
Current status: Ongoing
Programme title: 3rd Health Programme (2014-2020)
EC Contribution: € 4 999 999,56