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Il Progetto Woman II
Autore: Prof. A. R. Genazzani
Ultima Revisione: 17/10/2002
Most women live long enough to become postmenopausal. Modern technology
and medical science have improved human health drastically,
especially in industrialised countries. As a consequence, mean
life expectancy for women in developed countries has increased:
the average life length of the female population has grown in
the last century from 40 to 82. The mean age of the Western
women at menopause is around 51, so women live almost 30 years
of their lives (one-third lifetime) in the postmenopausal period.
Menopause is not a disease, but it can be associated with discomfort
due to symptoms such as hot flashes and sleep disturbances,
a decreased quality of life and an increase in serious disease
risks (osteoporosis, cardiovascular diseases, colon cancer,
etc.). Menopause affects every woman, and women are now living
longer than ever before. Unfortunately longer life does not
mean better quality of life, hence the health decisions made
at menopause are a significant public health issue: it has been
demonstrated that the costs associated with menopause consequences
are going to grow in the next years and could be decreased with
a better women health management.
It has been reported that the lack of a correct and useful
information is one of the greatest problems for women who
face the menopausal transition and Internet, if properly used,
might be a perfect media for information publishing. Currently,
the health related web sites are the most frequently accessed
sites on internet, and web users often print the contents
found on the web to discuss them with their GPs and health
professionals. A great number of web sites are currently treating
the menopause issue. These web sites may be divided into three
main groups:
1. web sites created
by industries (pharmaceutical industries, biomedical equipment
industries,…): these sites usually offer focused information,
normally only in English; unfortunately sometimes the border
between information and advertisement is not so clear;
2. web sites created by
national and international associations: the content of these
sites is really of a good quality, but unfortunately they
are only in English or in the local idiom;
3. web sites created by
single/groups of doctors/ women: the information is usually
in the local idiom and is restricted and of low quality.
It seemed to WOMAN consortium, that there was a lack
for an independent European web site, that offered high quality
and verified content in all European languages, regarding women
health in general and menopause in particular, so in
WOMAN project, an EC funded (1998-2000) TAP
project, this web site (www.womanlab.com) was created,
which offers now good quality information for women and health
professionals, in four languages. This information has to be
improved, up dated and culturally translated in all European
languages, within WOMAN-II.
It is also well known that health professionals are asking
for continuity of care and interactions between different
healthcare providers working in the women health domain (GPs,
gynecologists, menopause centers).
Differences
in the various European regions in terms of genetic, cultural,
dietary and environmental factors can influence the menopause
and its related consequences in terms of morbidity and mortality,
and thus in terms of individual and social costs. Exchanging
and comparing information can lead to discriminate between
the local and common features in the different European regions.
An efficient primary prevention of the leading causes of morbidity
and mortality is linked to true and active women participation.
This participation and prevention will reduce not only the
direct healthcare costs but also hidden or consequence costs
due to disease treatments. Preventing the development of serious
diseases obviously is desired not only from a medical point
of view, but also from an economical one.
There
is an increasing attention to the menopause and related health
problems, even if no all the physicians agree with the use
of the treatments such as HRT (Hormone Replacement Therapy).
In fact, some physicians and a great number of postmenopausal
women consider menopause as a natural status and thus they
sustain that there is no need of any treatment. The great
majority of HRT users require HRT for relieving vasomotor
symptoms (hot flashes, sleep disturbance, deterioration in
sexual functions) and for the prevention of osteoporosis.
Only few women are aware for example of the correlation between
HRT and prevention of cardiovascular risk since their physicians
are often not informed about the effects of menopause and
HRT on cardiovascular risk.
By these considerations it is evident that a better understanding
of the menopausal problem is linked to the possibility to
have an easier access to information and data in a large proportion
of our population of postmenopausal women throughout Europe
to exchange and compare the experience of different centres,
offering women an integrated system of highly specialised
healthcare providers.
In the field of the menopause and its related therapies,
large-scale trials are needed in Europe, necessitating a well-organized
international collaborative approach to guarantee the quality
and quantity needed to reach scientifically significant data.
Through co-ordination of well designed clinical trials in
healthy women as well as in specific risk populations, in
addition to stimulating basic research at an European level,
the researchers aim is to find conclusive data, whilst solving
those women's health issues which still pose questions.
The WOMAN I project, created an innovative Electronic
Patient Record (EPR) for data collection, management and
exchange. The WOMAN EPR has been created thanks to
the clinical experience of reference Menopause Centres, using
innovate Java/XML technologies, and represents a milestone
in the creation of a real European standard in the menopausal
data collection, elaboration and exchange.
Other peculiar services have been created (Online advice
and Online booking) creating an integrated and collaborative
web working environment.
These results have already been presented to the Research
Community. The EMAS, European Menopause and Andropause
Society Executive and Committee Boards have met the WOMAN
consortium in different meetings and have officially endorsed
the WOMAN results and decided to consider the WOMAN results
as the European standard, in order to create a real network
to collect data and experiences in a homogeneous way.
The EMAS approval is a very important achievement and will
grant dissemination of results and effective consensus within
the European market. A great number of partners proposing
WOMAN-II, belong to the EMAS Board reinforcing a strong collaboration
between WOMAN and EMAS. The WOMAN consortium is now planning
to present the WOMAN project also to the IMS (international
Menopause Society) in order to promote a real international
standard.
The results achieved in WOMAN are currently "time to
market". A small number of further developments are needed
for applying with success the solutions developed in the context
of WOMAN to an European market. In this sense, the most important
activity to be carried out is to validate the WOMAN products
and services against a complete European user group.
The Consortium aims to obtain early competitive advantage
with the respect to US competitors and the possibility to
pass the barriers to successful exploitation. The work to
be faced is the adaptation, tuning, customization and improvement
of the already available WOMAN results towards the European
users' needs.
| Table
I: Menopause Factors Affecting Quality of Life |
- vasomotor
and sleep disturbances
- psychological
and emotional stress
- genitourinary
and sexual complaints
- osteoporosis
: backache, fractures
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Il Progetto Woman II
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