“Managing Chronic Obstructive Pulmonary Disease: An Interprofessional Approach”
Background: Prior to COVID-19, chronic lower respiratory diseases, including COPD, represented the 3rd leading cause of death in the US, following heart disease and cancer. These leading diseases are all linked--- COPD increases the risk of cardiovascular disease and lung cancer by two-fold or more, while lung cancer and cardiovascular disease are the leading causes of morbidity and mortality in patients with COPD. This project aimed to develop an interprofessional annual wellness visit that would allow for comprehensive management of COPD and its comorbidities, mitigation of symptoms, and development of strategies for primary and secondary prevention.
Methods: A team of nine pre-licensure health professional students received interprofessional education in the form of a two-year longitudinal curriculum that included engaging directly with a community member and case-based learning. The team reviewed relevant literature to create an annual wellness visit for patients diagnosed with COPD who are classified as ‘most disadvantaged’ by the Area Deprivation Index (ADI). Each student made evidence-based suggestions for screening and diagnostics from the perspective of their respective health professions. Duplicated services were removed, and the team discussed prioritization of procedures/tests that were most necessary, based on best practice guidelines for COPD.
Results: The developed wellness visit consists of assessments, diagnostic procedures, screenings, and treatment from a healthcare team comprised of medical, dental, nursing, and respiratory therapy professionals. The total estimated cost was $829.69 for Louisiana residents with Medicaid. Predicted benefits of the interprofessional approach include decreased likelihood of errors, avoidance of unnecessary testing, multiple perspectives on health management, and increased patient satisfaction.
Conclusions: While an interprofessional annual wellness visit can be more expensive than a traditional visit, this approach is grounded in holistic care of the patient and organization of the most efficient treatment plan. Furthermore, it allows for streamlined operations and enhanced wellness of the healthcare team. Utilizing an interprofessional approach can help to reduce complications and long-term sequelae of COPD, which could reduce costs significantly over time.
Reflections: Interprofessional collaboration is vital to effective patient-centered care, as health decisions made by a diverse team of health professionals with a wide array of knowledge and expertise are generally more comprehensive. Collaboration and an enhanced understanding of other professions offers valuable benefits for both providers and patients. This includes prioritization of health equity and addressing factors beyond clinical treatment (including social determinants of health, education, and health literacy), which ultimately serves to improve population health and wellbeing.