OBJECTIVES: Since 2012, the Italian Medicines Agency (AIFA-Agenzia Italiana del Farmaco), with the cooperation of CliCon, has been providing and updating the OsMed Health-DB Database, a nationwide standardized monitoring system to provide analyses, reports, and trends on appropriateness of medicines’ use and medication persistence, to inform decision-makers in order to improve health outcomes and to avoid wasting of health-care resources METHODS: The OsMed Health-DB Database has two main components with distinct but complementary functions: a data-warehouse, a repository containing the integrated demographic, pharmaceutical and hospital discharges administrative data kept by Local Health Units (LHUs) and Regional Health Units (RHUs) and a dashboard, a set of performance indicators, with updates scheduled every six months, evaluating the prescription adherence to preset standards of some chronic pathologies at the local, regional, and national level. In 2014, 36 LHUs and 5 RHUs provided data, covering all Italian Regions and the data-warehouse stored information of about 30 million patients (almost the 50.0% of the entire Italian population). RESULTS: The 2014 OsMed Report reported the trend of 34 indicators on appropriateness and adherence of 10 chronic diseases: hypertension, hypercholesterolemia, diabetes mellitus, COPD, osteoporosis, depression, ulcers and esophagitis, anemia, psoriasis and rheumatoid arthritis. The average age of the LHU sample resulted 44.0 years versus