Submit to Medicina Review for Medicina Propose a Special Issue

Journal Menu

Journal Browser

Advances in Public Health and Healthcare Management for Chronic Care

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (30 June 2025) | Viewed by 10626

Share This Special Issue

Special Issue Editors

Prof. Dr. Fabio Petrelli

E-Mail Website
Guest Editor

School of Pharmacy, Polo Medicina Sperimentale e Sanità Pubblica "Stefania Scuri", Via Madonna delle Carceri 9, 62032 Camerino, Italy
Interests: diabetes public health; diabetes management; diabetes health management; diabetes health care; diabetes chronic care; diabetes nursing care
Special Issues, Collections and Topics in MDPI journals

Dr. Giovanni Cangelosi

E-Mail Website
Guest Editor Assistant

Units of Diabetology, ASUR Marche, Area Vasta 4, 63900 Fermo, Italy
Interests: public health; chronic disease; healthcare management; prevention; health management; lifestyle medicine; nursing practice

Special Issue Information

Dear Colleagues,

This Special Issue of Medicina will focus on the management of chronic diseases. Systematic/scoping/narrative reviews or protocols of reviews related to these issues are welcome. One of the primary focuses is to identify news model of care for different chronic diseases in Medical and Nursing practice. These approaches should promote an improving satisfaction for patients and the community. In chronic care, the personalized management of care improves clinical and psychosocial outcomes, and innovative models have been recommended in several areas of clinical practice, with significantly positive results in the quality of care and patient satisfaction, emphasizing the individual needs of each patient, and directing care in this same direction. This Special Issue aimed to demonstrated with our studies that it is necessary to place the patient in the center of care, to increase better results and health-related quality of life in general. Topics of interest include, but are not limited, to the following:

Investigation based on practice and personalized care approaches in chronic care;
New managed models in chronic diseases or other condition with long-term care;
Studies investigating promotion of care;
Nurse-led care;
Intervention for the management of chronic diseases;
New approaches of chronic care;
Health Economics evaluation.

You may choose our Joint Special Issue in Healthcare.

Prof. Dr. Fabio Petrelli
Guest Editor

Dr. Giovanni Cangelosi
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

chronic diseases
long-term care
nursing practice
public health
patient satisfaction
health economic

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (10 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Review, Other

15 pages, 1218 KiB

Open AccessArticle

Using Artificial Neural Network Models (ANNs) to Identify Patients with Idiopathic Normal Pressure Hydrocephalus (INPH) and Alzheimer Dementia (AD): Clinical Psychological Features and Differential Diagnosis

by Lara Gitto, Carmela Mento, Giulia Massini, Paolo Massimo Buscema, Giovanni Raffa, Antonio Francesco Germanò and Maria Catena Ausilia Quattropani

Medicina 2025, 61(8), 1332; https://doi.org/10.3390/medicina61081332 - 23 Jul 2025

Viewed by 432

Abstract

Background and Objectives: Patients with idiopathic normal pressure hydrocephalus (INPH) present similar symptoms as other diseases, such as dementia (AD). However, while dementia is not reversible, INPH dementia can be treated through neurosurgery. This study aims to assess the Rorschach method as a valid tool to identify INPH patients. Materials and Methods: The perception characteristics of a small sample of patients (n = 19) were observed through the Rorschach Inblok test. Artificial neural network (ANN) models allowed us to analyze the correlations between patients’ cognitive functions and perception characteristics. Results: The results obtained revealed significant insights about the independent traits in patients’ patterns of response with INPH and AD. In performing the test, patients with INPH and AD concentrated more on the cards displayed and what they perceived, while other patients concentrated on reactions related to the image proposed. Conclusions: The Rorschach test is a valid predictor tool to identify INPH patients who could successfully be treated with neurosurgery. Hence, this methodology has potential in differential diagnosis applied to a clinical context. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

► Show Figures

Figure 1

11 pages, 285 KiB

Open AccessArticle

by Jung Yoon Park, Hyoung Moo Park, Youn-Jee Chung, Mee-Ran Kim, Kyung Jin Hwang and Jae-Yen Song

Medicina 2025, 61(7), 1301; https://doi.org/10.3390/medicina61071301 - 19 Jul 2025

Viewed by 306

Abstract

Background and Objectives: Body composition changes with aging and menopause, often leading to increased adiposity and a shift in fat distribution. While BMI is commonly used in clinical practice, it does not accurately reflect fat mass or distribution. This study aims to evaluate age-related changes in both total and regional adiposity using DXA-derived indices in Korean women aged ≥ 40 years and to assess the limitations of BMI-based obesity classification. Materials and Methods: This retrospective multicenter study analyzed the DXA scans and clinical records of 914 Korean women aged 40–80 years who attended menopause clinics across multiple institutions between 2018 and 2021. We analyzed five adiposity indices: body mass index (BMI), total body fat percentage (TB%F), fat mass index (FMI), visceral adipose tissue (VAT) area, and android-to-gynoid (A/G) fat ratio. Excess adiposity was defined as BMI ≥ 23 kg/m², TB%F ≥ 40%, FMI ≥ 9 kg/m², VAT > 100 cm², or A/G ratio > 1.0. Age group comparisons were made using ANOVA, and misclassification was assessed by comparing BMI with other indices. Results: Mean BMI increased with age, peaking in the 60s before declining in the 70s. TB%F and FMI peaked in the 50s, while VAT and A/G ratio increased continuously with age. Excess adiposity was found in 41.9% of women by TB%F, 40.5% by FMI, and 59.4% by VAT in the 70s. Notably, 22% of women with normal BMI (<23 kg/m²) had VAT > 100 cm², and 35.7% had A/G > 1.0, indicating central obesity. Conclusions: DXA-based indices provide a more accurate assessment of adiposity and associated cardiometabolic risks in aging women than BMI alone. Clinical screening strategies should consider incorporating regional fat distribution markers, particularly in midlife and postmenopausal populations, to better identify individuals at risk. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

14 pages, 2032 KiB

Open AccessArticle

Five-Year Sales Trends of Osteoporosis Medications in Korea: A Market Analysis Based on IMS Health Sales Audit Data (2018–2023)

by Jung Yoon Park, Youn-Jee Chung, Mee-Ran Kim and Jae-Yen Song

Medicina 2025, 61(5), 805; https://doi.org/10.3390/medicina61050805 - 26 Apr 2025

Viewed by 934

Abstract

Background and Objectives: Osteoporosis is a common chronic condition after menopause that increases the risk of fractures. In South Korea, the prevalence of osteoporosis among adults aged 50 and older is 22.4%, with 94.4% of treated patients being women, highlighting its significant impact on postmenopausal health. In this study, we examine the sales trends of osteoporosis medications in Korea from 2018 to 2023 to understand current usage patterns and market dynamics. Materials and Methods: This study is a retrospective analysis based on pre-recorded sales data from Intercontinental Marketing Services (IMS). Data covering a five-year period (2018–2023) were analyzed to examine the sales trends of osteoporosis medications, including bisphosphonates, selective estrogen receptor modulators (SERMs), parathyroid hormone analogs, denosumab, romosozumab, and others. Romosozumab, approved in November 2019, was included in the analysis. Given the nature of this study, no direct patient data or clinical interventions were involved. Results: The total market size for osteoporosis medications in South Korea reached USD 285.42 million in 2023, reflecting a 15.3% increase from 2022. Bisphosphonates, previously the dominant therapy, experienced an 11% decline in market share over five years. Meanwhile, denosumab, a receptor activator of the nuclear factor-κB ligand inhibitor, showed a remarkable growth rate of 957.6% from 2018 to 2023, surpassing bisphosphonates in their market share. Romosozumab, a newly introduced anabolic agent, accounted for 7.4% of the market, with sales increasing by 59% in 2023. Conclusions: This analysis revealed major shifts in treatment preferences, with newer drugs like denosumab and romosozumab gaining prominence over traditional bisphosphonates. These trends highlight the increasing clinical adoption of anabolic agents for high-risk patients and the impact of expanded reimbursement policies on osteoporosis management. Given the increasing use of advanced therapies, it is essential to monitor treatment access, patient adherence, and long-term clinical outcomes. Understanding these sales trends can aid healthcare professionals and policymakers in optimizing osteoporosis treatment strategies and ensuring better patient care. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

► Show Figures

Figure 1

16 pages, 516 KiB

Open AccessArticle

The Impact of Standard Care Versus Intrinsic Relaxation at Home on Physiological Parameters in Patients with Fibromyalgia: A Comparative Cohort Study from Romania

by Theodora Florica Borze (Ursu), Annamaria Pallag, Emilian Tarcău, Doriana Ioana Ciobanu, Felicia Liana Andronie-Cioară, Carmen Delia Nistor-Cseppento, Gabriela Ciavoi and Mariana Mureșan

Medicina 2025, 61(2), 285; https://doi.org/10.3390/medicina61020285 - 7 Feb 2025

Viewed by 852

Abstract

Background and Objectives: Fibromyalgia (FM), through the presence of widespread chronic pain, stiffens the musculoskeletal system and causes sleep disturbances and fatigue. Through this study, we aimed to compare the effectiveness of two different recovery interventions for improving sleep quality: a standard, multidisciplinary intervention in a recovery hospital versus a therapy focused on intrinsic relaxation at home. Materials and Methods: This study included 60 adult patients who participated voluntarily and were diagnosed with FM by a rheumatologist, randomly divided into two groups. During this study, 30 patients out of the 60 were randomly assigned to experimental group 1 and underwent treatment at the Recovery Clinical Hospital in Băile Felix. The other 30 patients were assigned to experimental group 2 and underwent treatment at home. They were assessed on the first and last day of the recovery program using the Fatigue Severity Scale (FSS) and the Pittsburgh Sleep Quality Index (PSQI). Results: In experimental group 1, where by patients underwent hospital recovery (EG1), the results show that the severity of fatigue (FSS) was significantly reduced, with p = 0.00 and an effect size of 0.77, which suggests a general improvement in the state of fatigue, as well as in the quality of sleep evaluated with the PSQI (p = 0.00, effect size = 0.55). In experimental group 2 (EG2), no change was observed between assessments in terms of the FSS, but in terms of the quality of sleep, there was a small decrease in the PSQI score (p = 0.083), with a small effect size of 0.09. Conclusions: The results show that, from a clinical point of view, a complex treatment carried out daily improves sleep quality and reduces fatigue. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

► Show Figures

Figure 1

12 pages, 306 KiB

Open AccessArticle

Evaluation of Hypertension-Related Knowledge, Medication Adherence, and Associated Factors Among Hypertensive Patients in the Aljouf Region, Saudi Arabia: A Cross-Sectional Study

by Bashayer Farhan ALruwaili

Medicina 2024, 60(11), 1822; https://doi.org/10.3390/medicina60111822 - 6 Nov 2024

Cited by 1 | Viewed by 2464

Abstract

Background and Objectives: Hypertensive patients’ knowledge and adherence to prescribed medicines are critical in managing their condition, as poor adherence may lead to adverse cardiac and cerebrovascular events. The present study assessed hypertension-related knowledge and medication adherence among hypertensive patients attending primary health centers (PHCs) in the Aljouf Province, Saudi Arabia. Materials and Methods: Using a cross-sectional design, we conducted this survey on 390 patients. Self-reported hypertension knowledge was assessed using the Hypertension Knowledge Level Scale (HK-LS), and medication adherence was determined using the Hill–Bone Medication Adherence Scale. We used binomial regression analysis (adjusted with other variables) to find the associated factors of medication adherence. Results: This study found that nearly half (49.2%) of the participants had inadequate knowledge, and poor medication adherence was noted in 40.8% of the participants. We found a positive correlation between HK-LS and the Hill–Bone Medication Adherence Scale scores (Spearman’s rho = 0.312, p = 0.002). Medication adherence was significantly associated with job status (private sector (ref: public sector, adjusted odds ratio [AOR] = 2.02, 95% CI = 1.18–3.62, p = 0.005)), living in an urban region (ref: rural, AOR = 3.61, 95% CI = 1.85–5.72, p = 0.002), and duration since diagnosis of more than 5 years (ref: ≤1 year, AOR = 3.53, 95% CI = 2.36–4.95, p = 0.001). Conclusions: The present study findings indicate that there is still a critical gap in managing hypertension at the PHCs in this region, and this may lead to poor health outcomes among the patients and burden the healthcare system. Hence, continuous patient education and targeted counseling are recommended for those with poor medication adherence. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

8 pages, 279 KiB

Open AccessArticle

Relationship between Cancer and Intention to Leave Work among Older Workers: A Cross-Sectional Internet-Based Study

by Ryutaro Matsugaki, Shinya Matsuda and Akira Ogami

Medicina 2024, 60(9), 1506; https://doi.org/10.3390/medicina60091506 - 15 Sep 2024

Viewed by 1184

Abstract

Background and Objectives: Limited research has focused on the relationship between cancer, job loss, and factors associated with job loss among older workers. Therefore, in this study, we aimed to examine the relationship between cancer and intention to leave and between physical-health-related issues, mental-health-related issues, and cancer-related symptoms and intention to leave among older workers with cancer. Materials and Methods: This cross-sectional internet-based study included 4498 workers aged 60–75 years. Intention to leave was assessed based on whether individuals considered quitting their current jobs in the near future. Results: A multivariate logistic regression analysis showed a significant association between cancer and intention to leave (adjusted odds ratio [aOR]: 1.42, 95% confidence interval [CI]: 1.01–2.00, p = 0.045). In addition, physical-health-related issues (aOR: 2.33, 95% CI: 1.10–4.92, p = 0.026) and mental-health-related issues (aOR: 4.44, 95% CI: 1.80–10.98, p = 0.001) were significantly associated with the intention to leave. Conclusions: Healthcare providers and employers must address the physical- and mental-health-related issues facing older workers with cancer to help them secure their employment. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

Review

Jump to: Research, Other

20 pages, 1387 KiB

Open AccessReview

Barriers and Facilitators to Artificial Intelligence Implementation in Diabetes Management from Healthcare Workers’ Perspective: A Scoping Review

by Giovanni Cangelosi, Andrea Conti, Gabriele Caggianelli, Massimiliano Panella, Fabio Petrelli, Stefano Mancin, Matteo Ratti and Alice Masini

Medicina 2025, 61(8), 1403; https://doi.org/10.3390/medicina61081403 - 1 Aug 2025

Viewed by 111

Abstract

Background and Objectives: Diabetes is a global public health challenge, with increasing prevalence worldwide. The implementation of artificial intelligence (AI) in the management of this condition offers potential benefits in improving healthcare outcomes. This study primarily investigates the barriers and facilitators perceived by healthcare professionals in the adoption of AI. Secondarily, by analyzing both quantitative and qualitative data collected, it aims to support the potential development of AI-based programs for diabetes management, with particular focus on a possible bottom-up approach. Materials and Methods: A scoping review was conducted following PRISMA-ScR guidelines for reporting and registered in the Open Science Framework (OSF) database. The study selection process was conducted in two phases—title/abstract screening and full-text review—independently by three researchers, with a fourth resolving conflicts. Data were extracted and assessed using Joanna Briggs Institute (JBI) tools. The included studies were synthesized narratively, combining both quantitative and qualitative analyses to ensure methodological rigor and contextual depth. Results: The adoption of AI tools in diabetes management is influenced by several barriers, including perceived unsatisfactory clinical performance, high costs, issues related to data security and decision-making transparency, as well as limited training among healthcare workers. Key facilitators include improved clinical efficiency, ease of use, time-saving, and organizational support, which contribute to broader acceptance of the technology. Conclusions: The active and continuous involvement of healthcare workers represents a valuable opportunity to develop more effective, reliable, and well-integrated AI solutions in clinical practice. Our findings emphasize the importance of a bottom-up approach and highlight how adequate training and organizational support can help overcome existing barriers, promoting sustainable and equitable innovation aligned with public health priorities. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

► Show Figures

Figure 1

23 pages, 544 KiB

Open AccessReview

Integrated Hospital–Territory Organizational Models and the Role of Family and Community Nurses in the Management of Chronic Conditions: A Scoping Review

by Gianluca Azzellino, Patrizia Vagnarelli, Mauro Passamonti, Luca Mengoli, Lia Ginaldi and Massimo De Martinis

Medicina 2025, 61(7), 1175; https://doi.org/10.3390/medicina61071175 - 28 Jun 2025

Viewed by 376

Abstract

Background and Objectives: One of the challenges of modern healthcare systems, in terms of economic and organizational sustainability and the impact on patients’ quality of life, is the progressive increase in chronicity and care complexity. In this scenario, hospital–community integration models represent possible strategies to ensure the continuity of care, reduce readmission rates, and improve clinical outcomes. This study aims to map integrated care models for patients with chronic diseases, with active involvement of the family and community nurse, describing their functions and associated clinical, organizational, and economic outcomes, as well as barriers and facilitators to their implementation. Materials and Methods: The review was conducted using the JBI methodology and the PRISMA-ScR protocol and identified 26 studies with a publication range from 2000 to 2025. Results: The emerging results highlight the use of integrated and personalized organizational models in the post-discharge phases, with a leading role for the family and community nurse in the assessment, planning, and coordination of various steps. Conclusions: The interventions are associated with an increase in patient and caregiver satisfaction, a reduction in outcomes such as the rehospitalization rate, and greater continuity of care. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

► Show Figures

Figure 1

Other

Jump to: Research, Review

13 pages, 2890 KiB

Open AccessSystematic Review

Vitamin D Deficiency in Kazakhstani Children: Insights from a Systematic Review and Meta-Analysis

by Indira Karibayeva, Galiya Bilibayeva, Assiya Iglikova, Aya Yerzhanova, Roza Alekesheva, Makhigul Maxudova and Neilya Ussebayeva

Medicina 2025, 61(3), 428; https://doi.org/10.3390/medicina61030428 - 28 Feb 2025

Viewed by 930

Abstract

Background and Objectives: Kazakhstan’s unique geographic, dietary, and cultural factors contribute to the widespread occurrence of vitamin D deficiency across the entire country population, particularly among children. This study aims to assess the mean prevalence of vitamin D deficiency in children in Kazakhstan and determine whether it differs between healthy and non-healthy children, as well as between infants and older age groups. Materials and Methods: A comprehensive literature search was performed across five databases by two researchers. Studies were eligible if they were observational and provided the number of children with serum 25-hydroxyvitamin D levels below 20 ng/mL out of the total number of children assessed in Kazakhstan. Results: Eleven studies were included in the analysis, assessing 1396 children, of whom 714 had the outcome of interest. The pooled mean estimate of vitamin D deficiency among children was 56% (95% CI, 46–65%), with particularly concerning rates among infants at 65% (95% CI, 44–82%). No substantial differences were observed between healthy and non-healthy children. Conclusions: The prevalence of vitamin D deficiency among children is alarmingly high. These results highlight the urgent necessity of tackling vitamin D deficiency as a public health priority. Incorporating vitamin D deficiency prevention into Kazakhstan’s national healthcare program is vital for improving child health outcomes and reducing the long-term burden of associated complications. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

► Show Figures

Figure 1

11 pages, 1847 KiB

Open AccessSystematic Review

Prevalence of Vitamin D Deficiency Among Adults in Kazakhstan: A Systematic Review and Meta-Analysis

by Indira Karibayeva, Galiya Bilibayeva, Aya Yerzhanova, Roza Alekesheva, Assiya Iglikova, Makhigul Maxudova and Neilya Ussebayeva

Medicina 2024, 60(12), 2043; https://doi.org/10.3390/medicina60122043 - 11 Dec 2024

Cited by 3 | Viewed by 1981

Abstract

Background and Objectives: Despite frequent references to the high prevalence of vitamin D deficiency in Kazakhstan, a comprehensive synthesis of existing research on this issue among adults is lacking. This systematic review and meta-analysis aim to address this gap by determining the mean prevalence of vitamin D deficiency among adults in Kazakhstan. A secondary objective is to evaluate whether the prevalence differs between healthy adults and those with chronic conditions. Materials and Methods: A systematic search was conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar by two independent researchers using the keywords: “vitamin D” AND “Kazakhstan”, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they reported the prevalence of vitamin D in adults in Kazakhstan, defined as a blood level of 25-hydroxyvitamin D 25(OH)D below 20 ng/mL. Results: Seven studies were included in this review, encompassing 3616 individuals, of whom 2239 had vitamin D deficiency. Using a random-effects model, the pooled mean prevalence of vitamin D deficiency among adults with chronic conditions was 60% (95% CI, 38–79%), with high heterogeneity. Similarly, the analysis of five studies involving healthy adults revealed a pooled mean prevalence of 55% (95% CI, 38–70%), also with high heterogeneity. Overall, the pooled mean prevalence of vitamin D deficiency in the adult population was 57% (95% CI, 45–69%). Conclusions: This analysis indicates a high prevalence of vitamin D deficiency among adults in Kazakhstan, with 57% of the population affected. Addressing this issue requires a multifaceted approach, including policy reforms that consider the impact of time zone changes on sunlight exposure and the active involvement of nurse practitioners in preventive strategies. Full article

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

► Show Figures

Journal Menu

Journal Browser

Advances in Public Health and Healthcare Management for Chronic Care

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (10 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI