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(Adnkronos Salute) - Il 25% della popolazione (15 milioni di italiani) convive con una patologia della pelle, circa 6 milioni fanno i conti con una malattia infiammatoria cronica. Condizioni dermatologiche acute (es. scabbia) e croniche (es. psoriasi, vitiligine) possono portare a stigmatizzazione sociale, scarsa qualità della vita e diminuzione della produttività lavorativa. Non solo, le malattie della pelle croniche autoimmuni si accompagnano a comorbidità e ad un aumento di fattori di rischio evitabili con efficaci e tempestivi interventi di diagnosi e cura. Nonostante la loro elevata incidenza e prevalenza, per queste patologie mancano dati di buona qualità. Anche nelle rilevazioni ufficiali di Istat e Iss sulla diffusione della cronicità non sono ricomprese le malattie croniche della pelle a differenza di diabete, ipertensione, infarto acuto del miocardio. È quanto emerso in occasione dell’incontro 'Equity Group – Malattie croniche della pelle' che si è svolto a Roma alla presenza di esperti, specialisti dermatologi, associazioni di pazienti, rappresentanti delle istituzioni, politici ed esponenti delle professioni sanitarie coinvolte nell’assistenza, e realizzato grazie al contributo non condizionato di Bristol Myers Squibb, Incyte, UCB Pharma."Per questi pazienti aumentano difficoltà di accesso alle cure per mancanza di attenzione nella programmazione nazionale e regionale – afferma Tonino Aceti, presidente di Salutequità - Inoltre, abbiamo registrato una drastica riduzione delle visite dermatologiche del Ssn nel 2022. Le patologie croniche della pelle hanno pieno diritto di avere la stessa dignità delle altre patologie anche in termini di attenzione nei Piani di programmazione di riferimento, come quello per le cronicità. Servono dati, più accurati, ottenibili solo attraverso una maggiore consapevolezza dell’impatto che queste malattie hanno sulle persone e sul Ssn".La psoriasi – è stato ribadito nell'incontro - riguarda in Italia una persona su 10 con cronicità o multi-cronicità (1,8 milioni su 24 milioni). Colpisce circa il 3% della popolazione con importanti conseguenze sulla qualità della vita e le relazioni sociali. I costi annuali per paziente in Italia, considerando quelli sostenuti da Ssn e quelli out of pocket, sono 11.434 euro (International Federation of Psoriasis Associations). Altra patologia la vitiligine, che colpisce l’1% della popolazione mondiale, finora non riconosciuta nei Lea e troppo spesso ancora considerata solo un mero difetto estetico di macchie sulla pelle. In realtà il 15,3% dei pazienti - hanno sottolineato gli esperti - presenta una o più condizioni autoimmuni: l’artrite reumatoide ha in questi pazienti una frequenza maggiore del 100%; i linfomi hanno un’incidenza maggiore di quattro volte; il lupus di 5 volte. La malattia autoimmune più frequente, presente in più di un caso su dieci di chi soffre di vitiligine, è l’ipotiroidismo, con un’incidenza maggiore di circa il 75% rispetto alla media nazionale. E chi ne è affetto ha una probabilità 5 volte maggiore di sviluppare depressione. Stando ai dati sull’attività in intramoenia pubblicati dall’Agenas – è stato evidenziato durante 'Equity Group – Malattie croniche della pelle' - nel 2022 accedere a una visita dermatologica è stato più complicato rispetto al 2019 e persino rispetto al pieno periodo pandemico: le prestazioni a disposizione per gli assistiti ai fini di una diagnosi o di controlli nelle quattro rilevazioni annuali sono state 5154 (gli altri anni le rilevazioni erano 3 ndr) contro le circa 11.000 del triennio precedente, oltre la metà in meno rispetto ai 3 anni precedenti. Alert da non trascurare arriva dalla mancanza di attenzione nella programmazione nazionale, a partire dal nuovo Piano nazionale cronicità che nella bozza più recente le ha lasciate fuori dalla parte seconda: il risultato è all’assenza di Pdta regionali e di pochi Pdta aziendali (prevalentemente ospedaliero/universitari) su malattie diffuse come la psoriasi, la vitiligine, etc. Ci sono anche segnali positivi: Parlamento e Regioni – secondo gli esperti - stanno dimostrando sensibilità politica rispetto alle malattie della pelle: mozioni, ordini del giorno, risoluzioni sono stati approvati, ma devono tradursi in atti vincolanti per garantire più equità per le persone con malattie croniche della pelle. Per questo motivo Salutequità - laboratorio italiano per l’analisi, l’innovazione e il cambiamento delle politiche sanitarie e sociali - ha delineato alcuni passaggi fondamentali: 1.accessibilità, tempestività e appropriatezza nell’accesso alle prestazioni per una presa in carico multidimensionale, capace di prevenire le complicanze e favorire l’aderenza grazie al supporto psicologico e alla telemedicina; 2. tutele e capacità di stare al passo con i tempi dei Lea; 3. semplificazione ed efficienza organizzativa. "È necessario non solo l’aggiornamento dei Lea – rimarca Aceti - per introdurre patologie e prestazioni indispensabili per un trattamento al passo con i tempi, ma anche avere tempi certi della relativa attuazione. Quelli del 2017 sono ancora al palo".Per superare le difficoltà nell’accesso le Regioni hanno messo in campo iniziative diverse. L’Osservatorio di Salutequità ha rilevato che ad esempio il Veneto ha attivato un avviso pubblico per l’attribuzione di incarichi individuali per specialisti in dermatologia e venereologia, fissando in deroga ai regimi tariffari ordinari, una remunerazione oraria fino a un massimo di 100 euro lordi omni-comprensivi per il personale medico, fino a 60 euro per il personale del comparto sanitario e 40 euro per gli specializzandi. La Puglia ha, invece, puntato sulla istituzione della rete dermatologica regionale ed il tavolo tecnico regionale in dermatologia per razionalizzare e implementare l’assistenza sanitaria, mettendo in rete ospedale e territorio; definire Pdta e indicatori per misurare volumi, qualità ed esiti; supportare un piano di comunicazione sulle malattie della pelle. Attualmente sembra avere una battuta d’arresto. I consigli regionali di Lombardia, Abruzzo, Lazio, Liguria, hanno promosso iniziative per attivare reti dermatologiche regionali, riconoscere nei Lea patologie come la vitiligine e migliorare la presa in carico delle persone con psoriasi. Diversi i provvedimenti per favorire appropriatezza prescrittiva in Piemonte, Calabria, Sicilia, Veneto, Emilia Romagna. La Sicilia ha istituito un tavolo tecnico regionale per la psoriasi e fa riferimento nel Piano della rete territoriale di assistenza, alla dermatologia come ambito su cui lavorare a reti regionali e Pdta. di Adnkronos   10-07-2024 - 11:26 Link copiato Commenti Leggi la Netiquette

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