Clinical pathways for family wellness promotion for older persons in Family and Community Practice

ABSTRACT

Background@#The Philippine Health Agenda 2016-2022 seeks to uphold every Filipino’s right to health consistent with the International Alma ATA Declaration that health is a fundamental human right as well as the PAFP mission CARES. One of the objectives in the Expanded Senior Citizens Act of 2010 is to give full support for the improvement of the total wellbeing of the elderly. In accordance with this objective, the Act shall establish a program beneficial to the senior citizens, their families and the community they serve. This underscores the need to promote and provide wellness program among patients and their families. Several guidelines have been developed for Clinical Preventive Services by various organizations. @*Objective@#The overall objective of this pathway is to improve the quality of health care of the Filipino family through health maintenance, promotive and preventive care.@*Methods@#The PAFP Clinical Pathways Group reviewed published clinical practice guidelines and medical literature to identify, summarize, and operationalize the content of the following history, physical examination, tools for comprehensive geriatric assessment, screening for risk factors, pharmacologic and non-pharmacologic interventions. Indicators or outcomes to develop an evidence-based clinical pathway in family medicine practice were identified. @*Recommendations@#Recommendations were made based on the number of visits. During the first visit, all elderly patients consulting at the clinic for wellness should have a thorough history, physical examination and comprehensive geriatric assessment. In screening for risk factors, request for FBS, lipid profile, pap smear and fecal occult blood test. For immunization, the following maybe given influenza, pneumococcal, Tdap and herpes zoster vaccines. Multivitamins, calcium and Vitamin D should be prescribed. Patients should be educated on appropriate diet and physical activities. Interventions to promote smoking cessation and moderate alcohol drinking should be done. @*Implementation@#Education, training and audit are recommended strategies to implement the clinical pathway.