Transforming Chest Care: Integrating Medicine, Pharmacy, Nutrition And Health Administration Practices For Improved Patient Wellbeing

Abstract

Chronic respiratory diseases place a substantial burden on patients and healthcare systems worldwide. Effective management requires a multifaceted approach addressing medical, lifestyle, and psychosocial factors. However, care is often fragmented between specialties with inadequate communication and coordination. Integrated care models aim to overcome these barriers through collaboration between medical, nursing, pharmacy, nutrition, and administrative teams.

The purpose of this review was to develop and evaluate an integrated care model for patients with chest diseases incorporating medicine, pharmacy, nutrition, and health administration practices. We hypothesized this model would improve patient outcomes and staff satisfaction compared to usual care.

Integrated medication management practices play an important role in enhancing patient well-being for those with chest conditions.

A multidisciplinary team was formed at a large academic medical center including physicians, pharmacists, dietitians, care coordinators, and administrators. Standard protocols and order sets were developed for common chest conditions such as COPD, asthma, pneumonia, and lung cancer incorporating pharmacological, dietary, and lifestyle recommendations based on national guidelines. The first 100 patients who received integrated care were compared as a case group to the previous 100 historical control patients who received usual care. The primary outcome was medication adherence measured by pharmacy refill records. Secondary outcomes included weight loss for overweight/obese patients, 30-day hospital readmissions, and staff satisfaction surveys.

The case and control groups had similar demographics and disease characteristics. Integrated care patients had significantly higher medication adherence rates compared to controls.  Among overweight/obese patients, integrated care was associated with a mean weight loss of 3.2 kg compared to 0.8 kg in controls.

Our findings suggest integrating medicine, pharmacy, nutrition, and administrative practices can transform chest care delivery and improve patient outcomes. Several limitations should be noted. As a single-center study, our findings may not be generalizable. Unmeasured confounders could have influenced outcomes. Larger randomized trials are needed to verify our conclusions. Future research should evaluate the cost-effectiveness and sustainability of integrated care programs.

This review provides promising initial findings on the impact of integrated care models for transforming our approach to pulmonary disease management. By coordinating efforts across medicine, pharmacy, nutrition, and administration through a dedicated multidisciplinary team.

While preliminary, these results offer proof of principle that we must overcome entrenched organizational, financial, cultural and technological barriers inhibiting integration of our practices. This study illuminates a promising direction worthy of further shared investigation and piloting through cooperative spirit. Progress will depend on our willingness to combine innovations from every specialty for the benefit of all.