BRIDGE implementation science study to improve chronic spontaneous urticaria outcomes in Italy

Delay in diagnosis and referral to a specialist negatively affects the quality of life of patients with uncontrolled chronic spontaneous urticaria (CSU). The BRIDGE implementation science study is evaluating the effectiveness and feasibility of implementing strategies aiming to improve care for patients with CSU.

Our aim was to present findings from a contextual analysis of the unmet needs of CSU management in Italy and describe the design of the BRIDGE study, which was developed to address those gaps.

BRIDGE is a hybrid, effectiveness-implementation science study with a pre-post design involving general practitioners (GPs). A Consolidated Framework for Implementation Research-guided contextual analysis was performed to identify barriers to and facilitators of development and implementation of a strategy aiming to improve care for patients with CSU in Italy.

The barriers to effective management of patients with CSU include lack of awareness of, familiarity with, and knowledge about optimal care for patients with CSU and patient-reported outcomes (PROs), as well as lack of resources for PRO assessment. Additionally, there is an absence of well-established processes and practices for collaboration and effective communication between GPs and CSU specialists. The following implementation strategies were recommended for optimization of CSU care in Italy: (1) targeted training for GPs, guidelines, and utility of PROs to support decision making; (2) development of a guide for GPs to rapidly identify patients with CSU; and (3) improvement of referral networks.

GPs in Italy require additional education and support to improve management of patients with CSU. The BRIDGE study incorporates the aforementioned findings into development and implementation of a tailored educational program, the Urticaria Care Package, to improve care for patients with CSU in Italy.