ADVERTISEMENT

Development and Implementation of a Geriatric Walking Clinic

The overall quality of life of older veterans living in a rural area improved by participating in a patient-centric, home-based walking program.
Federal Practitioner. 2016 August;33(8):44-47
August 12, 2016|Federal Practitioner
Kalpana P. Padala, MD;Prasad R. Padala, MD;Tanya Taylor, BSN, RN;Brittany Montgomery;Shelly Y. Lensing;Melinda Bopp;Patricia M. Dubbert, PhD;Dennis H. Sullivan, MD
Author and Disclosure Information

Dr. Kalpana Padala is a staff physician/researcher, Dr. Prasad Padala is the associate director for clinical programs, Ms. Taylor is clinical demonstration projects coordinator, Ms. Montgomery is a health science specialist, Ms. Lensing is a statistician, Ms. Bopp is a research programs coordinator, Dr. Dubbert is a staff clinical psychologist/researcher, and Dr. Sullivan is director, all at the Little Rock Geriatric Research Education and Clinical Center (GRECC) of the Central Arkansas Veterans Healthcare System in Arkansas. Dr. Kalpana Padala is an assistant professor, Dr. Prasad Padala is an associate professor, and Dr. Sullivan is a professor, all in the D.W. Reynolds department of geriatrics at the University of Arkansas for Medical Sciences (UAMS) in Little Rock. Dr. Prasad Padala also is an associate professor in the department of psychiatry at UAMS.

Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.

Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies.

Limitations

Results of this QI project need to be considered in light of its limitations. One of the most important limitations is the design of the project. Since this was a clinical initiative and not a research study, there was no control group or randomization. There were also limitations on data availability. HbA1c tests were not ordered as part of this QI project. Instead, baseline HbA1c was set equal to the most recent of any value obtained clinically within 2 months before the participant’s GWC enrollment; the 6-week follow-up value was set to any HbA1c obtained within 2 months after the 6-week visit. It is also recognized that factors other than the veterans’ participation in the GWC (eg, alterations in their DM medication regimen) may have contributed to the changes noted in some participant’s HbA1c. Although not necessarily a limitation, 140 of the 247 participants (57%) were enrolled in MOVE! as well. MOVE! is a widely popular weight management program in the VA focusing on diet control.18 The authors, however, have no information about the veterans’ adherence to MOVE!

Five immediate next steps to disseminate the program have been identified (Table 2).

Conclusion

The GWC was successfully developed and implemented as a QI project at CAVHS and was met with much satisfaction by older veterans. Participants experienced clinically significant improvements in physical performance and other health indicators, suggesting that these benefits could potentially offset clinic costs.

ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT