Managing Multiple Chronic Conditions: Challenges in the Care of Older Adults

An increasing number of people are living with Multiple Chronic Conditions (MCC). These older adults with MCC experience a high level of “illness burden” (poor quality of life, depression, “treatment burden” (multiple uncoordinated visits, polypharmacy) and lack of person-centered care (low continuity, lack of focus on patients’ priorities). This module covers optimizing care for older adults with MCC by reducing treatment burden and unplanned care. Participants will recognize the guiding principles to assist in the overall care management of MCC which aim to improve quality of life by promoting shared decisions based on what is important to each person in terms of treatments, health priorities, lifestyle and goals. The patient-centered approach to managing the challenges of care for older adults with MCC will be reviewed and practice strategies to enhance care will be provided.

Michael Koronkowski, PharmD, BCGP

Michael Koronkowski, PharmD, CGP
Clinical Assistant Professor Department of Pharmacy Practice
College of Pharmacy
Co-Investigator, ENGAGE-IL University of Illinois at Chicago

Author Bio
Dr. Michael J. Koronkowski received his B.S. in Pharmacy in 1986 from Drake University College of Pharmacy and Health Sciences. His Pharm.D. degree was conferred in 1990 from Purdue University College of Pharmacy and Pharmacal Sciences. He completed a Pharmacy Practice Residency program at the Philadelphia College of Pharmacy in 1992 and a Fellowship in Geriatrics at the University of North Carolina at Chapel Hill in conjunction with Duke University and Glaxo Research Institute in 1994.

Dr. Koronkowski joined the faculty at the University of Illinois at Chicago in 1994 as a Clinical Assistant Professor in the Department of Pharmacy Practice. Currently, he practices in Internal Medicine/Geriatrics as a Clinical Pharmacy Practitioner at the University of Illinois Hospital and Health System. His research interest include: geriatric pharmacotherapy management, adverse drug reactions, medication safety, post-acute care transitions, and evidence-based interdisciplinary practice models. Current research program funding is ongoing through the Illinois Department on Aging (IDoA), Chicago Department of Family Support Services, Senior Services, White Crane Wellness Center, Age Options-Area Agency on Aging targeting community-based senior wellness and the Department of Health and Human Services, Health Related Services Administration (DHHS-HRSA) Geriatric Workforce Enhancement Programs entitled ENGAGE-IL and CATCH-ON targeting Older Adults with Multiple Chronic Conditions in Primary Care.

Editors:
Valerie Gruss PhD, APN, CNP-BC
Associate Professor
College of Nursing
Director, ENGAGE-IL
University of Illinois at Chicago

Memoona Hasnain MD, MHPE, PhD
Professor and Associate Department Head, Faculty Development & Research
College of Medicine,
Department of Family Medicine
Co-Director, ENGAGE-IL
University of Illinois at Chicago

Expert Interviewee:
Heather E. Whitson, MD, MHS
Associate Professor of Medicine (Geriatrics)
Duke University School of Medicine
Deputy Director, Duke Aging Center

Expert Bio:
Dr. Heather E. Whitson, MD, MHS is an internist, geriatrician, and clinical investigator. She is an Associate Professor with Tenure in the Departments of Medicine and Ophthalmology at Duke University School of Medicine, Deputy Director of the Duke Center for the Study of Aging and Human Development, and a research physician in the Durham VA’s Geriatrics Research Education and Clinical Center. Her research agenda seeks to improve health and independence for older adults with multiple chronic conditions (MCC). Dr. Whitson has particular interest and expertise related to the interface between age-related changes in vision and cognition. She leads two translational studies that probe the link between degenerative diseases of the brain and eye, incorporating brain MRI, retinal imaging, and neurocognitive data. This research is characterizing how the brain responds to the stressor of late-life vision loss, with the ultimate goal to protect cognitive function. Dr. Whitson participates in a number of national initiatives to raise awareness about the population health impact of vision impairment as an important comorbidity in older Americans.

Dr. Whitson leads the Pilot and Exploratory Studies Core of the Duke Claude D. Pepper Older American Independence Center (aka Duke Pepper Center). She has contributed substantially to the Duke Pepper Center’s theme: to optimize older adults’ physiological reserve and physical resilience to health stressors. As a thought leader in the emerging field of physical resilience, Dr. Whitson is co-PI of a multi-site, national study on physical resilience called the Physical Resilience Indicators and Mechanisms in the Elderly (PRIME) Collaborative. Whether as an investigator, physician, mentor, or advocate, her work relates to an over-arching objective: to raise awareness, expand the knowledge base, and create better treatment options that will improve health for older adults living with multiple conditions.

Duration: 30 minutes
Format: Video Stream & pdfs

Handout – One Slide Per Page

Handout – Three Slides Per Page

Resources and References

In support of patient care, Rush University Medical Center is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education for the healthcare team.

Rush University Medical Center designates this live activity for a maximum of (0.50) AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

This activity is being presented without bias and without commercial support.

ANCC Credit Designation – Nurses
The maximum number of hours awarded for this CE activity is 0.50 contact hours.

Rush University is an approved provider for physical therapy (216.000272), occupational therapy, respiratory therapy, social work (159.001203), nutrition, speech-audiology, and psychology by the Illinois Department of Professional Regulation. Rush University designates this live activity for (0.50) Continuing Education credit(s).

Rush University Medical Center designates this knowledge based CPE activity (JA0000275-0000-18-078-H04-P, JA0000275-0000-18-078-H04-T) for 0.50 contact hours for pharmacists.

Upon completion of this module, learners will be able to:

Discuss the terminology, epidemiology, and impact of MCC
Describe the patient care management challenges of MCC
Discuss the guiding principles of MCC
Describe the approach to care of the older adult with MCC
Identify resources to support the care management of MCC

For technical support, please notify engage@engageil.com.

To report a complaint, please contact the ENGAGE-IL Program Help Desk at engageIL@engageil.com.

This ENGAGE-IL learning activity fully complies with the legal requirements of the ADA and the rules and regulations thereof. Learners with special needs can make requests for accommodation at any time by sending e-mail to engageIL@engageil.com.