A little can go a long way:Improving quality of life and cardiovascular health of aging adults through interprofessional engagement; physical therapy, pharmacy and nutritional pharmacy
Purpose: To determine if 4, 1 - 2 hour interprofessonal sessions of physical therapy education by a PT and PT student including balance screening and basic exercise/activity tips, consultation and medication review by a pharmacist and pharmacy students, and education by a nutritional pharmacist, could make an impact on managing chronic CVD in aging adults over a 3.5 month period. It also examined how the professions worked together and learned about each other.Methods/Description: Participants were recruited at 2 Accountable Care Organizations from an at risk CVD cohort. Sessions occurred at each ACO. Pre- and post- surveys were administered; the Short Form (SF)-36 Health Survey and Activities-Specific Balance Confidence (ABC) Scale. Medication adherence before and after intervention was assessed. A self designed post survey was administered to determine if participants integrated the information into their daily lives. The 4 sessions included: Overview of CVD, benefits of activity including balance and grip strength screening, instruction in simple exercise, importance of medication adherence and consultation and the role of nutrition. Pharmacy, nutrition and physical therapy sessions were completed separately, with the team present at each to answer questions and facilitate discussion. Ongoing discussion occurred between pharmacy faculty and students and physical therapy faculty and student, to learn about each other's roles.Results/Outcomes: Both the physical therapy student and the pharmacy students learned about each other's profession and their respective roles in managing individuals with CVD. There was little difference in the standard survey results administered pre and post intervention. The self designed outcome survey however, determined integration of information and learning, and was completed by 12/21 participants with 11/12 usable. All survey responses were positive and reinforced the active learning faciliated by the interprofessional approach. All 11 participants were integrating at least some of the information and instruction on a regular basis and had increased their physical activity levels. They reported feeling better overall and had developed strategies to remember to take their medications and had changed at least some eating habits.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: Interprofessional cooperation between physical therapy and pharmacy over short period of time resulted in change. Engaging group screenings and related instruction may be effective in facilitating increased activity in aging adults with CVD relative to balance and increasing activity (exercise). Integrating simple suggestions into usual and customary daily activities resulted in self reported increases in activity, even in subjects who had been sedentary. Providing heart stress/squeeze balls facilitated self reported use during seated activities such as watching TV. Even infrequent educational sessions resulted in self reported positive changes relative to modifiable risk; activity/exercise, improved diests and improved adherence to drug regimen.References: 1. American Heart Association http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp#.WpmeVnmovcs https://www.nhlbi.nih.gov/health/educational/hearttruth/lower-risk/risk-factors.htm 2. http://www.apta.org/NEXT/News/2016/6/6/ChronicDisease/ 3. https://www.cdc.gov/heartdisease/index.htm 4. https://www.nhlbi.nih.gov/health/educational/hearttruth/lower-risk/what-is-heart-disease.htm 5. https://www.cdc.gov/dhdsp/pubs/guides/best-practices/index.htm">https://www.cdc.gov/dhdsp/pubs/guides/best-practices/index.htm Best Practices for Cardiovascular Disease Prevention Programs 6. Berra, K, Franklin, B, Jennings, C (2017) Community-based healthy living interventions. Progress in Cardiovascular Diseases 59(5): 430–439. Google Scholar, Crossref, Medline 7. Pearson, TA, Palaniappan, LP, Artinian, NT. (2013) American heart association guide for improving cardiovascular health at the community level, 2013 update: A scientific statement for public health practitioners, healthcare providers, and health policy makers. Circulation 127(16): 1730–1753. Google Scholar, Crossref, Medline