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This project aims to define a proximity model, in accordance with recent developments in the Italian healthcare landscape, engaging over 150 healthcare stakeholders and potentially impacting approximately 14,000 patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>An analysis was pursued to map the multiple sclerosis pathway, followed by interviews to capture the actual implementation in Italian Multiple Sclerosis Centers. Through the experts\u2019 insights, an optimal proximity care pathway and a Maturity Model framework were defined. This model was piloted in 14 centers, and a preliminary pre-post analysis was performed to evaluate initial improvements. Finally, a two-round Delphi method validated the Maturity Model dimensions and a set of key performance indicators. A scientific board including neurologists, patient associations and scientific associations, supervised project progresses and methodologies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The Pilot study results show an overall increase in the centers\u2019 positioning within the Maturity Model levels after adopting center-specific action plans. To generalize the model, the Delphi panel validated a subset of process, volume, outcome and patient experience indicators (9 of 26 proposed) along with qualitative dimensions defining the Maturity Model (13 of 20 proposed), therefore, outlining a comprehensive monitoring framework for the multiple sclerosis patient pathway.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This study shows, for the first time in Italy, the efficacy of a bottom-up approach in addressing organizational challenges within the current multiple sclerosis scenario. 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Claudio Gasperini received fee as speaker and advisory board by Almirall, Biogen, Merck, Sanofi, Novartis, Astra Zeneca, Sandoz, Roche. Girolama Alessandra Marfia has served as an advisory board member and received speaker honoraria, congress, travel and accommodation expense compensations from Alexion, Almirall, Merck Serono, Amgen, Bayer, Janssen Cilag, Bristol Myers-Squibb, Novartis, Roche, Biogen and Sanofi Genzyme. Carlo Avolio received honoraria for speaking, consultation fees and research grants from Biogen, Merck, Novartis, Roche, Sanofi, BMS, Alexion, Amgen. He is an Advisory Board member of Biogen, Merck, Novartis, Roche, Sanofi, BMS, Alexion, Amgen. Roberto Bergamaschi has served on scientific advisory boards, received funding for travel, speaker honoraria, research support from Biogen, Bristol Myers Squibb\/Celgene, Janssen, Merck-Serono, Novartis, Roche, Sanofi-Genzyme. Marco Capobianco received personal compensation for consulting from Alexion, Biogen, Roche, Novartis, Sanofi, and Merck; research grant from Roche, Novartis and FISM. Michele Dotta has served on scientific advisory boards and received funding for travel and meeting participation, speaker honoraria, research support from Abbvie, Biogen, Merck-Serono, Novartis, Roche, Sanofi-Genzyme. Luigi M.E. Grimaldi in the last two years has served on scientific advisory boards, received funding for travel, speaker honoraria, research support from Biogen, Novartis, Merck, Roche, Bristol Myers Squibb, Janssen, Sanofi-Genzyme, Alexion. Giacomo Lus has served on scientific advisory boards, received funding for travel, speaker honoraria, research support from Alexion, Horizon, Biogen, Bristol Myers Squibb\/Celgene, Janssen, Merck-Serono, Novartis, Roche, Sanofi-Genzyme. Eugenio Pucci during the 36\u00a0months prior to the submission, has received research support from \"Associazione Marchigiana Sclerosi Multipla e altre malattie neurologiche\u2014ODV-ETS. Rocco Quatrale has nothing to disclose. Carmen Angioletti, Maria Cristina Gallottini, Simone Parretti, Luca Pinto: IQVIA employment; IQVIA received professional service fees from Biogen. Sveva Sanzone and Francesco Pavone: are employees of and may hold stock\/stock options in Biogen.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"96"}}