scholarly journals INTERDISCIPLINARY CURRICULUM FOR THE CARE OF OLDER ADULTS: CREATING NETWORKS OF COLLABORATIVE LEARNERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S294-S294
Author(s):  
Pamela Yankeelov ◽  
Anna Faul ◽  
Joe D'Ambrosio ◽  
and Samantha G Cotton
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Self Efficacy ◽  
Interprofessional Education ◽  
Evaluation Model ◽  
Interdisciplinary Approach ◽  
Knowledge Score ◽  
Interdisciplinary Teams ◽  
Multiple Chronic Conditions ◽  
Patient Centered

Abstract Serving older adults with multiple chronic conditions and variable social, emotional, or physical support effectively within the primary care setting requires an interdisciplinary approach to care. Our GWEP program has developed an interprofessional education center that educates and prepares students and professionals from social work, medicine, nursing, dentistry, pharmacy, and community health partners, to function within a transformed integrated patient-centered geriatric primary care and community-based service delivery system. Learners from multiple disciplines attend a face-to-face Interdisciplinary Case Management Experience (ICME) session lasting 2.5 hours. Sessions include learners from each discipline and, if possible, at least one community practitioner in small groups of 6–8 learners at each table facilitated by 1 faculty member. Approximately 1,200 learners have received the curriculum. To evaluate the program, Kirkpatrick’s Training Evaluation Model was used to determine if learners were satisfied with the content, skilled, and confident in their abilities to utilize the curriculum. Learners completed a satisfaction survey after taking each module, along with an interdisciplinary geriatric care knowledge test and self-efficacy test before and after taking each module to measure learning outcomes. Analysis showed that learners, irrespective of discipline, were satisfied with the program. All disciplines showed a significant increase from pre- to posttest for all 5 online modules achieving a mean post-knowledge score of 85% across all 5 online training modules. All disciplines experienced significant differences in their self-efficacy with working on interdisciplinary teams from pre to post ICME. Implications for future interprofessional curriculum will be discussed.

scholarly journals Fostering an Understanding of Interprofessional Approaches to Geriatrics

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 444-444
Author(s):  
Anna Faul ◽  
Pamela Yankeelov ◽  
Sam Cotton
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Social Work ◽  
Healthcare System ◽  
Evaluation Model ◽  
Interdisciplinary Approach ◽  
Interdisciplinary Teams ◽  
Multiple Chronic Conditions ◽  
Social Emotional ◽  
Physical Support

Abstract Serving older adults with multiple chronic conditions and variable social, emotional, or physical support effectively within the primary care setting requires an interdisciplinary approach to care, together with the integration of novel approaches to care coordination (Dorr et al, 2006). The purpose of this study is to examine the use of interprofessional learning models to educate a healthcare workforce that meets the needs of older adults by integrating geriatrics with primary care, maximizing patient engagement, and transforming the healthcare system. Specifically, the targeted learners for this curriculum were from a healthcare system in Belize that had no previous specialty training in interprofessional geriatrics care. The 4-day training took place in Belize with an interprofessional group of healthcare professionals that included social work, nursing and medicine. 100 learners participated in the trainings and including participants from social work, nursing and medicine. To evaluate the program, Kirkpatrick’s Training Evaluation Model (Kirkpatrick & Kirkpatrick, 2005) was used to determine if learners were satisfied with the content (reaction), skilled (knowledge & skill) and confident in their abilities to utilize the curriculum (application of knowledge & skills). Analysis showed that learners, irrespective of discipline, were satisfied with the program. All disciplines experienced significant differences in their self-efficacy with working on interdisciplinary teams from pre to post assessments. Specifically, there was an increase in learner’s confidence related to learning to work together cooperatively with other professions and how to communicate effectively with other members of an interprofessional team. Implications for future interprofessional curriculum will be discussed.

scholarly journals Older adults report cancellation or avoidance of medical care during the COVID-19 pandemic: results from the Longitudinal Aging Study Amsterdam

2021 ◽  
Author(s):  
Noah A. Schuster ◽  
Sascha de Breij ◽  
Laura A. Schaap ◽  
Natasja M. van Schoor ◽  
Mike J. L. Peters ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Medical Care ◽  
Help Seeking ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Hospital Outpatient ◽  
Longitudinal Aging Study Amsterdam ◽  
Aging Study ◽  
Longitudinal Aging Study

Abstract Purpose Delay of routine medical care during the COVID-19 pandemic may have serious consequences for the health and functioning of older adults. The aim of this study was to investigate whether older adults reported cancellation or avoidance of medical care during the first months of the COVID-19 pandemic, and to explore associations with health and socio-demographic characteristics. Methods Cross-sectional data of 880 older adults aged ≥ 62 years (mean age 73.4 years, 50.3% female) were used from the COVID-19 questionnaire of the Longitudinal Aging Study Amsterdam, a cohort study among community-dwelling older adults in the Netherlands. Cancellation and avoidance of care were assessed by self-report, and covered questions on cancellation of primary care (general practitioner), cancellation of hospital outpatient care, and postponed help-seeking. Respondent characteristics included age, sex, educational level, loneliness, depression, anxiety, frailty, multimorbidity and information on quarantine. Results 35% of the sample reported cancellations due to the COVID-19 situation, either initiated by the respondent (12%) or by healthcare professionals (29%). Postponed help-seeking was reported by 8% of the sample. Multimorbidity was associated with healthcare-initiated cancellations (primary care OR = 1.92, 95% CI = 1.09–3.50; hospital OR = 1.86, 95% CI = 1.28–2.74) and respondent-initiated hospital outpatient cancellations (OR = 2.02, 95% CI = 1.04–4.12). Depressive symptoms were associated with postponed help-seeking (OR = 1.15, 95% CI = 1.06–1.24). Conclusion About one third of the study sample reported cancellation or avoidance of medical care during the first months of the pandemic, and this was more common among those with multiple chronic conditions. How this impacts outcomes in the long term should be investigated in future research.

scholarly journals Seniors and Undergraduates Mutually Benefit From an Interprofessional Service-Learning Health Promotion Program

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 8-8
Author(s):  
Britteny Howell
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Service Learning ◽  
Learning Outcomes ◽  
Low Income ◽  
Interprofessional Education ◽  
Interdisciplinary Teams ◽  
Health Promotion Program ◽  
Positive Health ◽  
Promotion Program

Abstract Although benefits of service-learning and interprofessional education (IPE) have been separately well documented to be effective for students in gerontology and geriatrics courses, few curricula appear to integrate both aspects into a single course for undergraduate students in public health. This poster discusses the development and implementation of a service-learning health promotion program utilizing IPE embedded within two courses in two different departments at a mid-sized university. Students worked in interdisciplinary teams and acquired interprofessional educational learning outcomes while they engaged in their first experiences working with diverse older adults at a low-income, independent-living housing community. Twenty-five students (N=25) each team-taught 2 sessions on nutrition, physical activity, and stress reduction techniques in a 10-week program. Qualitative and quantitative results are presented which demonstrate significant learning outcomes from the students about the health needs of the aging population and increased comfort in working with older adults. Older participants in the program also reported positive health and psychological outcomes from their participation. Limitations, challenges, and next steps are also presented.

scholarly journals HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Jenny Ploeg ◽  
Marie-Lee Yous ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Home Care ◽  
Family Caregivers ◽  
Chronic Conditions ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions ◽  
Team Approach ◽  
Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

scholarly journals Evaluating the implementation of interdisciplinary patient-centred care intervention for people with multimorbidity in primary care: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046914
Author(s):  
Patrice Ngangue ◽  
Judith Belle Brown ◽  
Catherine Forgues ◽  
Mohamed Ali Ag Ahmed ◽  
Tu Ngoc Nguyen ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Structural Characteristics ◽  
Interdisciplinary Teams ◽  
Relative Advantage ◽  
Multiple Chronic Conditions ◽  
Design Quality ◽  
Patient Centred Care ◽  
Data Coding ◽  
Inner Setting

ObjectiveA patient-centred care interdisciplinary pragmatic intervention to support self-management for patients with multimorbidity was implemented in one region of Quebec, Canada. This embedded study aimed to evaluate the process of implementation.DesignA descriptive qualitative study was conducted in 2016–2017 using semistructured individual interviews. The Consolidated Framework for Implementation Research (CFIR) was used to guide the data coding, analysis and reporting of the findings.SettingThe study took place in seven Family Medicine Groups in one region (Saguenay-Lac-Saint-Jean) of Quebec, Canada.ParticipantsTen managers (including two family physicians) and 19 healthcare professionals (HCPs), nurses, kinesiologists, nutritionists and a respiratory therapist, were interviewed.ResultsMany key elements within the five CFIR domains were identified as impacting the implementation of the intervention : (1) intervention characteristics—evidence strength and quality, design quality and packaging, relative advantage and complexity; (2) outer setting—patients’ needs and resources, external policies and incentives; (3) inner setting—structural characteristics, networks and communication, culture, compatibility, readiness for implementation and leadership engagement; (4) characteristics of the managers and HCPs—knowledge and belief about the intervention; (5) process—planning, opinion leaders, formally appointed internal implementation leaders, reflecting and evaluating.ConclusionThis study revealed the organisational and contextual aspects of the implementation based on different and complementary perspectives. With the growing demand for interdisciplinary teams in primary care, we believe that our insights will be helpful for practices, researchers, and policymakers interested in the implementation of disease prevention and management programmes for people with multiple chronic conditions in primary care.Trial registration numberNCT02789800.

scholarly journals A Web-Based eHealth Intervention to Improve the Quality of Life of Older Adults With Multiple Chronic Conditions: Protocol for a Randomized Controlled Trial

10.2196/25175 ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. e25175
Author(s):  
David H Gustafson Sr ◽  
Marie-Louise Mares ◽  
Darcie C Johnston ◽  
Jane E Mahoney ◽  
Randall T Brown ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Primary Care ◽  
Health Care ◽  
Chronic Conditions ◽  
Health Care Use ◽  
Multiple Chronic Conditions ◽  
Secondary Outcomes ◽  
Ehealth Intervention

Background Multiple chronic conditions (MCCs) are common among older adults and expensive to manage. Two-thirds of Medicare beneficiaries have multiple conditions (eg, diabetes and osteoarthritis) and account for more than 90% of Medicare spending. Patients with MCCs also experience lower quality of life and worse medical and psychiatric outcomes than patients without MCCs. In primary care settings, where MCCs are generally treated, care often focuses on laboratory results and medication management, and not quality of life, due in part to time constraints. eHealth systems, which have been shown to improve multiple outcomes, may be able to fill the gap, supplementing primary care and improving these patients’ lives. Objective This study aims to assess the effects of ElderTree (ET), an eHealth intervention for older adults with MCCs, on quality of life and related measures. Methods In this unblinded study, 346 adults aged 65 years and older with at least 3 of 5 targeted high-risk chronic conditions (hypertension, hyperlipidemia, diabetes, osteoarthritis, and BMI ≥30 kg/m2) were recruited from primary care clinics and randomized in a ratio of 1:1 to one of 2 conditions: usual care (UC) plus laptop computer, internet service, and ET or a control consisting of UC plus laptop and internet but no ET. Patients with ET have access for 12 months and will be followed up for an additional 6 months, for a total of 18 months. The primary outcomes of this study are the differences between the 2 groups with regard to measures of quality of life, psychological well-being, and loneliness. The secondary outcomes are between-group differences in laboratory scores, falls, symptom distress, medication adherence, and crisis and long-term health care use. We will also examine the mediators and moderators of the effects of ET. At baseline and months 6, 12, and 18, patients complete written surveys comprising validated scales selected for good psychometric properties with similar populations; laboratory data are collected from eHealth records; health care use and chronic conditions are collected from health records and patient surveys; and ET use data are collected continuously in system logs. We will use general linear models and linear mixed models to evaluate primary and secondary outcomes over time, with treatment condition as a between-subjects factor. Separate analyses will be conducted for outcomes that are noncontinuous or not correlated with other outcomes. Results Recruitment was conducted from January 2018 to December 2019, and 346 participants were recruited. The intervention period will end in June 2021. Conclusions With self-management and motivational strategies, health tracking, educational tools, and peer community and support, ET may help improve outcomes for patients coping with ongoing, complex MCCs. In addition, it may relieve some stress on the primary care system, with potential cost implications. Trial Registration ClinicalTrials.gov NCT03387735; https://www.clinicaltrials.gov/ct2/show/NCT03387735. International Registered Report Identifier (IRRID) DERR1-10.2196/25175

scholarly journals Claims-Based Network Analysis of Disease Progressions in Complex and Non-Complex Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 672-673
Author(s):  
Peter Nicholas Onglao ◽  
Ciara Janer ◽  
Maria Eloisa Ventura ◽  
Lauren Bangerter
Keyword(s):  
Older Adults ◽  
Disease Progression ◽  
Disease Risk ◽  
Network Size ◽  
Social Needs ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Complex Patient ◽  
Complex Patients ◽  
Progression Patterns

Abstract Older adults are the fastest growing subset of complex patients with high medical, behavioral, and social needs. Understanding differences in disease progression patterns between complex and non-complex older adults is critical for understanding disease risk and tailoring patient-centered interventions. We identified complex patients as those having frequent medical encounters and multiple chronic conditions within the first year of the study period and non-complex patients as the converse. This study compares the disease progression patterns of (a) complex and (b) non-complex older adults by creating disease progression networks (DPN) from claims data of 762,362 patients (mean age = 73) from 2016 to 2020. We characterized the network size and density between the complex patient DPN (C-DPN) and non-complex patient DPN (NC-DPN), and compared disease progression incidence, time-to-progression, and age- and gender-related risk. Results show that the C-DPN was denser and had a wider range of values for risk of progression compared to the NC-DPN. This implies more varied disease progression patterns occurring in the complex adults. We were also able to compare (median) time-to-progressions of diseases relative to each subpopulation and found variation in disease progression time. Furthermore, k-means clustering on the network allowed us to identify highly connected diseases involved in many disease pathways that are prevalent among older adults. (e.g., lipoprotein disorders, hypertension, major depressive disorder). Our results suggest that DPNs can be used to identify important conditions and time-points for tailoring care to the complex and non-complex older adults.

scholarly journals CANCER, COGNITION, AND COMMUNICATION: A 2-DAY INTERPROFESSIONAL GERIATRIC PSYCHO-ONCOLOGY SYMPOSIUM

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S640-S640
Author(s):  
Natalie Gangai ◽  
Ruth Manna ◽  
Smita Banerjee ◽  
Rosario Costas Muniz ◽  
Christian Nelson ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Communication Skills ◽  
Cognitive Deficits ◽  
Self Efficacy ◽  
Geriatric Medicine ◽  
Skills Training ◽  
Complex Case ◽  
Patient Centered ◽  
Cognitive Changes

Abstract Background: Most cancer deaths are in patients older than 65 years. Healthcare professionals (HCPs) caring for older adults with cancer must be equipped with skills to manage cognitive related changes and the nuances of communication with patients and caregivers. Methods: A two-day interprofessional symposium was developed to increase knowledge regarding 1) chemotherapy-related cognitive changes; 2) distress, delirium, dementia and depression in older cancer patients; 3) communication with patients with cognitive deficits and their caregivers; 4) decision making capacity. Presenters include geriatric medicine, geriatric psychiatry, occupational therapy and legal, ethics and communication experts. Day one centered on didactics with a complex case interprofessional discussion. Day two comprised of a communication skills training consisting of three modules: Geriatrics 101, Communication and Cognitive Deficits and Shared Decision Making. Participants role-played with simulated older adult patients and caregivers. Knowledge, self-efficacy and satisfaction were assessed. Results: A total of 75 people attended day one and 33 people attended day two. Most attendees were white (74.4%) and female (85.4%). Nurses (36.6%), social workers (29.3%), physicians (14.6%), others (19.5%) were represented. Mean knowledge increased (t=-3.23, df (13), p<0.05) from pre (M=0.83) to post (M=0.96). Mean self-efficacy in communication skills increased significantly across the three modules from 3.33 to 4.51 on a 5-point Likert scale (t=-6.40, df=23, p<0.001). Discussion: This two-day symposium shows an increase of knowledge and self-efficacy among HCPs caring for older adults. Skills related to cognitive changes and communication are essential to providing patient-centered care and making shared decisions with older adults and their caregivers.

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