Department of Public Health · University of Basel

Research

Strategies of the Department of Public Health in view of research is to strengthen the next generation of health scientists based on strong PhD programs at the interface of science and education.

Highlights

SWISS TPH
SAPALDIA The only Swiss-wide chronic disease cohort with associated biobank. It was initiated in 1991 and has since been funded by the SNF, the Federal Offices for the Environment and Public Health, different Lung Leagues and cantons. SAPALDIA is at the center of national and international air pollution (FP7 Projects ESCAPE; Exposomics) and respiratory health research (Horizon2020 Project: ALEC). The rich risk factor, environmental and health data as well as the genome- and methylome-wide data is used in studies ranging from assessing the role of physical activity, sleep, and transportation noise in cardio-metabolic disease etiology to the evaluation of chronic disease diagnosis and treatment as well as aging in general
HBM4EU:  HBM4EU is a joint effort of 28 countries, the European Environment Agency and the European Commission, co-funded under Horizon 2020 with more than 70 Mio. Euro. The main aim of the initiative is to coordinate and advance human biomonitoring in Europe. HBM4EU will provide better evidence of the actual exposure of citizens to chemicals and the possible health effects to support policy making. The HBM4EU initiative represents a novel collaboration between scientists and chemical risk assessors and risk managers, including several Commission services, EU agencies and national representatives. The project will build bridges between the research and policy worlds and deliver benefits to society in terms of enhanced chemical safety. Swiss TPH and its Swiss partner network including the Federal Offices of Public Health and the Environment  and the Swiss Biobanking Platform will participate to the project with exposome expertise and population-based biobanks. Human biomonitoring is also providing the healthy citizen reference for the Swiss Personalized Health Network to which Swiss TPH actively contributes. Swiss TPH, represented by Prof. Dr. Nicole Probst-Hensch, is the Swiss grant signatory for the human biomonitoring initiative HBM4EU
ECPM
ECPM has been or is involved in several European Union-funded research projects. We also take responsibility, since 2007, for the outcomes research and health economic evaluation activities of the Swiss Group for Clinical Cancer Research (SAKK), the leading Swiss collaborative study group in the field of oncology and haematology. 
OPERAM:  Optimising PharmacothERApy in the Multimorbid elderly
Many older adults have multiple chronic diseases (multi-morbidity) and multiple medications (polypharmacy). However, multi-morbid patients are often excluded from clinical trials and most guidelines address diseases in isolation. OPERAM investigators developed STOPP/START criteria to detect inappropriate drug use, both over- and underuse. OPERAM performs a multicentre randomised controlled trial to assess the impact of a user-friendly software-assisted intervention to optimise pharmacotherapy and to enhance compliance in 1900 multi-morbid patients aged 75 years or older. OPERAM ultimately aims at better healthcare delivery in primary and hospital care, based on effective, safe, personalised and cost-effective interventions that can be applied to the rapidly growing older population in Europe. Within OPERAM, ECPM is responsible for the work package devoted to health economics.
OPERAM is EU HORIZON 2020-funded (grant agreement no. 634238) and supported by the Swiss State Secretariat for Education, Research and Innovation (contract no. 15.0137). As a collaborative research project, it involves clinical centres from Switzerland, Belgium, the Netherlands and Ireland, and additional institutions from Switzerland, Germany, Greece and Italy.
In older adults with multiple chronic diseases, polypharmacy and inappropriate prescribing can lead to severe side effects. They may be responsible for a substantial proportion of the hospital admissions occurring in this group of the population. Identifying better ways of avoiding such events is important for the wellbeing of patients and relatives, and may dampen the rise in healthcare costs.
INS
INTERCARE Nurse-led care models in Swiss nursing homes: improving interdisciplinary care for better resident outcomes. The increasing complexity of medical care in nursing homes and the lack of coordination between settings jeopardize nursing home (NH) care quality. Main issues are the lack of interprofessional collaboration and care coordination which lead to avoidable hospitalizations, associated with potential negative clinical and psychosocial outcomes and excess health care cost. This calls for new models of care to support NH care quality by enhancing care coordination, improving care workers’ geriatric expertise, and investing in effective clinical leadership in NH. One promising solution, well-established in other countries, but still to be implemented and tested in Switzerland, are nurse-led interprofessional care NH models. These models have shown to improve resident satisfaction, to empower NH staff, as well as clinical outcomes including a reduction in avoidable hospitalizations. Moreover, they are typically led by Advanced Practice Nurse or expert nurses and focus on residents’ needs assessment, care coordination between settings and different care providers, offer geriatric clinical leadership and support data-driven quality improvement. The aim of the INTERCARE project is to design a Swiss nurse-led care model for residents in complex care situations living in nursing homes and therefore to develop first evidence of the use of contextually appropriate, sustainable interprofessional nurse-led teams in Swiss nursing homes. Accordingly, the project aims to foster interprofessional care collaboration through a combination of interprofessional expertise, to facilitate care coordination, to strengthen geriatric expertise in nursing homes, and, lastly, to reduce avoidable hospitalizations, which may yield health care cost reduction. 

INTERCARE is an implementation science research project, which combines qualitative and quantitative methods to explore implementation processes and assesses the effectiveness of a new model of care. It addresses several key issues of the healthcare system in Switzerland including the development and assessment of new care models, interprofessional collaboration and the quality of care in nursing homes.

By addressing the increasing need for professional long-term care and care coordination for chronically ill older persons with complex clinical conditions, the INTERCARE project will provide a scalable interprofessional nurse-led care model that will adress NH resident’s access to and use of professional geriatric care and improve health outcomes. The model will deal with management of acute and chronic conditions while impacting positively on resident’s quality of life, functional ability and satisfaction. The project addresses the current shortages of nursing personnel and general physicians in nursing homes and influence the long-term care work environment by strengthening nurse’s position and aiming to reduce employee turnover. Moreover, the new model has the potential to reduce costs not only by improving chronic disease management in NHs and reducing avoidable hospitalizations, but by providing a scalable solution to the distribution of highly qualified personnel and other health care resources. Based on its results, policy suggestions will be provided concerning reimbursement possibilities for the interprofessional nurse-led care model and the project will support evidence-based decision making at the levels both of individual NH management and of health policy makers.

CPHC
Smarter Health Care Determinants of vaccine hesitancy and underimmunization with childhood and Human Papilloma Virus vaccines in Switzerland (NRP 74 Project “Smarter Health Care”)
i) To provide a detailed characterization of the medical, demographic, geographical and socio-cultural determinants of vaccine hesitancy and under-immunization in Switzerland, including parent and provider determinants;
ii) To assess the prevalence of vaccine hesitancy regarding individual childhood vaccines and human papilloma virus (HPV) vaccines and under-immunization in Switzerland;
iii) To use the knowledge generated in the setting of this proposal as the necessary background for the design and conduct of an appropriate pilot intervention, design of an appropriate knowledge transfer proposal and a randomized controlled trial to address vaccine hesitancy and increase vaccination rates in Switzerland.
Our findings will assist BAG/OFSP and cantonal health authorities design future vaccination programs (eg. rotavirus or varicella vaccine), and will help physicians address vaccine hesitancy in general when facing it.
Underimmunization and vaccine hesitancy are striking examples of the underuse of a safe, effective and cost-effective medical intervention, i.e. vaccination, and a public health issues of such great importance that the WHO has issued a call to action to investigate and understand its determinants. Information regarding the sociocultural, personal and demographic factors associated with vaccine hesitancy and underimmunization in Switzerland are highly limited and therefore represent a major unresolved research question, as regards childhood vaccines, pneumococcal conjugate vaccines in at risk adults >65 years and HPV vaccine in young women and men