Virtual Shared Medical Appointments for Patients with Chronic Obstructive Pulmonary Disease to Prevent Exacerbations

Introduction: COPD is one of the leading chronic conditions that result in hospital readmissions (Mihailoff et al., 2017). Evidence suggests that shared medical appointments (SMAs) have potential benefits for improved clinical outcomes and healthcare cost reductions (Kirsh et al., 2017). Telemedicine has value to patients, providers, and organizations for improved care of chronic conditions (AMA, 2020). Implementing SMAs with telemedicine in the format of virtual shared medical appointments (VSMAs) combines these evidenced-based interventions.

Research methodology: A review of the literature was conducted for scholarly peer-reviewed current articles for telemedicine and shared medical visits as healthcare treatment venues for patients with COPD. The literature chosen from reputable databases for this Integrative Review was narrowed to include evidence-based content for motivational interviewing (MI) and health coaching to promote treatment adherence for the prevention of exacerbations. The DNP student search included the databases of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, EBSCOhost Health Policy Reference Center, PubMed, PubMed Central, ProQuest Central Medline, and Medline complete which resulted in 21,249 articles. Keywords included in the search were telemedicine, shared medical appointments, group medical visits, virtual shared medical appointments, motivational interviewing, health coaching, self-management, social networking, and health-related quality of life using “AND” with Boolean phrases. The Johns Hopkins Research Appraisal Tool was used to appraise articles for the final determination of 15 articles with evidence-based findings for inclusion into this Integrative Review (Dang & Dearholt, 2017).

Results and discussion: VSMAs have positive benefits for convenient patient access, revenue-producing for the organization, self-management skills in group settings for treatment adherence, social networking, and prevention of exacerbations with opportunities for nurse facilitation.

Conclusions: Telemedicine is an effective modality for healthcare delivery. SMAs are an effective intervention of healthcare delivery for chronic diseases. Combining telemedicine with SMAs in the format of VSMAs is an evidence-based intervention for the care of patients with COPD.

Further recommendations: MI is recommended as a tool to implement with VSMAs. MI has been found to promote treatment adherence in patients with COPD (Naderloo et al., 2018). MI implemented within VSMAs, could sustain the prevention of exacerbations requiring ED visits.

References

1) American Medical Association. (2020). Telehealth Implementation Playbook. Retrieved February 12, 2021.from https://www.ama-assn.org/syste...
2) Dang, D., & Dearholt, S. (2018). Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines (3rd ed.). Sigma Theta Tau International.
3)    Kirsh, S. R., Aron, D. C., Johnson, K. D., Santurri, L. E., Stevenson, L. D., Jones, K. R., &Jagosh, J. (2017). A realist review of shared medical appointments: How, for whom, and under what circumstances do they work? BioMed Central Health Services Research, 17(1), 1-13.
4)    Mihailoff, M., Deb, S., Lee, J. A., & Lynn, J. (2017). The effects of multiple chronic conditions on adult patient readmissions and hospital finances: a management case study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 0046958017729597.
5)    Naderloo, H., Vafadar, Z., Eslaminejad, A., & Ebadi, A. (2018). Effects of Motivational Interviewing on Treatment Adherence among Patients with Chronic Obstructive Pulmonary Disease: a Randomized Controlled Clinical Trial. Tanaffos, 17(4), 241.