Chronic disease prevalence

Introduction

Chronic disease prevalence continues to rise across all age groups, especially older adults. Most

(2) adults aged above 75 years are either facing one chronic disease or multiple chronic diseases.

The prevalence of this disease pose significant challenges to the caregivers and overwhelms the

healthcare system. Culture and social economic background play a significant role in the adverse

effects of chronic diseases, including mortality rate. For instance, in Australia, there is a

substantial gap in life expectancy between the Aboriginal and Torres Strait Islander communities

that is exacerbated by chronic diseases in adults. Approximately 80% of the mortality gap

between Indigenous and other Australians aged between 35 and 74 years (10) is attributed to

chronic disease. Ideally, the high prevalence of chronic diseases, particularly in people aged

above 35 years, is associated with interrelated factors such as (1) risk behaviors like alcohol and

substance abuse and aspects related to service provision and access and disease management and

treatment. Other risk factors among the indigenous communities associated with social and

economic disadvantages include lack of proper housing, high illiteracy level, and lack of

employment. Carers (11) have a massive responsibility to change lifestyles among elderly

patients in order to reduce chronic disease risks. Pharmacists also have a critical role in

supporting both healthcare professionals and patients in managing chronic diseases. This report

outlines the planning, design, implementation, evaluation, and reflection of public health

presentations on chronic disease risk reduction through lifestyle change.

Planning phase

Topic Selection and Rationale

Chronic diseases, also known (9) as non-communicable diseases (NCDs), are progressively

becoming prevalent across all age groups. The diseases mostly emerge in middle age after long

exposure to an unhealthy lifestyle, such as the use of drugs, sedentary living, and consumption of

foods rich in high saturated fats, sugars, and salts. An unhealthy lifestyle (1) makes one

susceptible to chronic diseases such as diabetes, obesity, heart disease, stroke, cancer, and

chronic heart disease. According to the World Health Organization, chronic health diseases

claim 74% of deaths globally. Additionally, according to (10) the Australian Institute of Health

and Welfare (AIHW), 94% of people aged 85 years and above live with one of multiple chronic

diseases. Death (9) from chronic diseases is more prevalent in low and middle-income countries

as three-quarters of all chronic disease deaths and 86% of the 17 million people that die before

the age of 70 years.

Moreover, these diseases pose detrimental health consequences for people, families, and

communities, as well as overwhelming the health systems. Following the (4) socio-economic

costs associated with chronic disease, prevention, and control is a significant development

imperative for the 21st century. Research shows that changing from an unhealthy lifestyle to a

healthy one can aid in the prevention of chronic diseases and can ease the adverse effects on

those already living with the diseases.

Factors contributing to the topic selection

1. The Prevalence (5) of chronic diseases and their effect on socioeconomic aspects.

Chronic diseases significantly affect an elderly's life, affecting their quality of life and

financial freedom and placing a huge burden on their families as well as overwhelming

the healthcare system.

2. Contribution (4) of lifestyle factors to chronic diseases. Research shows that modifying

lifestyle factors such as physical activity, nutrition, alcohol, and substance use can aid in

chronic disease risk reduction.

3. Significance (11) of carers' awareness and knowledge of chronic diseases and risk

reduction. Carers play a vital role in supporting and implementing lifestyle changes for

the elderly that can help reduce chronic disease risk.

4. Pharmacists’ duty: They (6) provide pharmacological and non-pharmacological

approaches to chronic disease treatment and management.

5. Relevance to (10) Australian local communities. Demographic data from AIWA show a

high prevalence of chronic diseases among the elderly population, especially in people

aged 65 and above.

Social economic determinants of health, such as healthcare access, literacy level, and income

level, are detrimental to chronic disease risk, diagnosis, treatment, and management. In

Indigenous communities, aspects such as limited access to specialized healthcare services and

low health literacy in older adults compel the need to empower (11) carers with information and

practices for chronic disease prevention, treatment, and prevention. Notably, cultural

considerations are also critical in offering the best care given the diverse backgrounds of the

carers and the elderly residents. For instance, while some cultures are conservative in their

dressing which may influence their choices of physical activities, other cultures are less

conservative, and dressing code would matter in choosing a physical activity.

Topic: Chronic disease risk reduction through lifestyle changes.

Aim: To educate carers in elders’ facilities on risk reduction of chronic diseases through lifestyle

changes

Objectives

1. To deliver a 60 minutes presentation to 25 carers from local elders’ facilities within one and

half months.

2. To create awareness of chronic diseases and reduce risk among the elderly and their

caregivers in elderly facilities.

3. To raise the participants’ awareness of chronic disease risks factors by 45%, which will be

measured by pre and post-presentation surveys.

4. To offer the audience five evidence based practices that aid in reduction of chronic disease

risks applicable in elderly facility set-up.

5. To achieve 75% satisfaction from the attending carers and older people.

Plan Approach

After choosing the project and its focus, a planning approach was established to ensure seamless

execution and relevance of the presentation to the target population. The plan approach was

carried out in steps: first, the pharmacist carried out a stakeholder consultation. This

consultation involved engaging with pharmacy staff, facility managers, and carers to obtain

insight into the current practices, challenges, and the necessity for lifestyle change in elderly

facilities for chronic disease risk reduction. Secondly, a literature review was carried out. This

step involved conducting an in-depth review of recent and evidence-based information on

chronic disease treatment and management among the elderly in care facilities. The third step

included an assessment of the project. After reviewing the literature, a specific knowledge and

awareness gap was established in areas of interest. The fourth step involved consideration of the

delivery method. In this step, aspects such as time constraints, carers' diverse training

backgrounds, and application of the intended practices in the elderly care setting are discussed.

The last step comprised interdisciplinary collaboration. This focus is on consulting with other

healthcare professionals like geriatricians, nutritionists, and physiotherapists to offer inclusive

and beneficial lifestyle practices for chronic disease risk reduction.

Design Phase

The design phase involved coming up with a plan to organize the public health presentation.

The presentation organization comprised of finalizing the content outline draft, putting in place

resources and logistics, pharmacy services, referral process, Budget and value for money.

Presentation Organization

The presentation was organization in 60 minutes, 45 minutes of presentation and 15 minutes for

question and answer session. It took place in a local elderly facility with a capacity of 30 people.

Holding the presentation in a local elderly facility was meant to ensure maximum attendance

and a familiar space for the elderly and carers.

Presentation content outline

I. Introduction

a. The presenting team introduced itself and gave the representatives of the carers

and the elderly to introduce themselves (5 Minutes)

II. Overview of common chronic diseases on elderly and their impact on their quality of

life, income, family and mental wellbeing (10 Minutes)

III. Risk factors associated with chronic diseases (10 Minutes)

IV. Evidence based practices for lifestyle modification and their implementation to reduce

chronic disease risks. (15 Minutes)

V. The role of medicine intervention in chronic disease risk reduction (5 minutes)

VI. Questions and answers (15 minutes)

VII. Vote of thanks from either one of the present elders or carers.

Resources and Logistics

The resources required for a successful presentation included a well-developed and visible

PowerPoint presentation, 25 copies of handouts that were to be issued to all attendees, laptop and

projector. The handouts comprised of information chronic diseases, their common risks and

intervention activities. It also included demographic data on common chronic diseases obtained

from Australian Institute of Health and Welfare(AIHA). The flyers were posted on the local care

facilities for the elderly a month before the presentation. The flyers included information on the

presentation venue, time, and theme. For the pharmacists to realize the impact of the

presentation in terms of carers and elderly awareness to chronic diseases risks reduction through

lifestyle change a forms for pre-survey and post-survey were issued before and after the

presentation.

Pharmacy Services

The pharmacy services required in the presentation included medication reviews, blood pressure

and glucose monitoring, support for smoking cessation, and advice on nutritional supplements.

These services helped in determining whether the attendees were at risk of chronic disease and

how they should manage the condition.

Referral process

At the end pf the presentation the pharmacist gave out relevant contacts to the attendees on

where they could do a follow up consultation as well as other professionals such as nutritionists

and physiotherapists. The pharmacists also gave an outline process for medication review

referrals.

Budget and Value for Money

Estimating the project budget crucial for ensuring sustainability and significance to the

pharmacy business. Budget estimation also guided the planner on spending on only the essential

aspects of the project. Short terms costs included printing materials, handouts and flyers at $120,

travel expenses at $50, team time for preparation at $400 and refreshments for all the attendees

at $100. Though the budget was expected to be $670, only $600 was spend as the team obtained

some of the commodities at discounted prices. The long term cost involved the likelihood for an

increase in time utilized on medication reviews and consultations and progressive educational

materials updates.

The pharmacists short-term benefits included an improved reputation and community health

resource, higher visibility within the local healthcare providers, and increased traffic of

medication review referrals. Besides, the pharmacist long term goals involved decreased risks to

chronic diseases among the elderly, improved job satisfaction for pharmacy staff via expanded

roles, enhanced relationship with the local healthcare providers, carers and older adults and a

bigger customer base from the elderly care facilities. Though some benefits such as decreased

chronic disease risk among the elderly will take time before being realized, the pharmacist has

increased traffic of referral customers from the local elderly facilities in need of medication

review.

Value for money

Though the immediate recovery of the all the funds spend may be limited, long term significance

such as increased customer engagement, high customer referral traffic and professional

development. The project value extends beyond presentation to community engagement,

professional development and potential increase in services offered to the community

particularly the elderly members of the community. As a result, the pharmacy will achieve

customer trust and loyalty essential for business growth.

Sustainability and Benefits

The public presentation can be carried out a yearly basis to keep the public aware and

knowledgeable on prevention and management of chronic diseases. The project can also be

expanded to all members of the community regardless of age for a healthy community and few

cases of chronic diseases in the future. For sustainability the pharmacy could introduce entrance

fee that would be used to cater for the presentation cost.

Risk Management

Identifying and mitigating project potential risks was critical for a successful public health

presentation. Some of the risks identified and mitigated include:

1. Low attendance risk due to staff commitments and lack of interests from the elderly and

carers. This risk was mitigated by early communication and organization with the staff to

ensure optimum attendance. The pharmacist also liaised with the heads of various local

elderly facilities. Besides, names of the elderly and carers attending the public health

presentation was given to their heads and passed to the pharmacist for attendance

assurance.

2. Information overload for the attendees’ severity risk. The risk was mitigated by using

clear, concise language fit all attendees regardless of their education level. Take home

educational levels were also given to the audience to help in their comprehension of the

presentation even at their facilities. Utilizing interactive elements like eye contact and

asking questions helped in assessing the audience. Also, the PowerPoint was developed

with large font for high visibility.

3. Challenges in implementing lifestyle changes in elderly care facilities as a result of

institutional rules. The risk was mitigated through involving the elderly facility

management in the plan and progressive education. Besides, all the practices

recommended were tailored to fit the facilities and were age appropriate to the elderly.

4. Likelihood of offering medical advice beyond practice severity scope. This risk was

mitigated by defining the pharmacist’s duties and limitations. Emphasizing on the

significance of interdisciplinary care and giving clear guidance on when to consult a

healthcare professionals helped in mitigating the challenge.

The pharmacy staff involved in the public health presentation was thoroughly trained on the

potential risks and their mitigation.

Implementation Phase

Marketing and awareness practices

The organizing team put in place the following strategies ensure extensive reach to the targeted

population.

1. In store marketing - Posters were placed strategically at the entrance of the pharmacy to

ensure all people entering the pharmacy notice it. Flyers were also hanged across all the

supermarkets and institution for a wide reach of the targeted audience.

2. Community outreach- posters and flyers were distributed all across all the elders’

facilities, medical and community centres. The pharmacist also sent personalized email

invitations to the elderly facility managers.

3. Professional networking- This networking involved contacting healthcare providers in

different capacities such as dieticians, and physiotherapists to inform them on the public

health presentation and invite their collaboration. This collaboration was effective for

offering diverse presentation and creating awareness to the carers and elderly on how to

make use of these professionals for better lifestyle.

4. Aggregate communication- the PowerPoint was developed in large font for high

visibility and the language used was Australian culture appropriate easily compressible

by all attendees.

The marketing materials used that is flyers, emails and posters included information such as

presentation theme, target audience, venue, date and time of the presentation. The marketing

materials also notified people on the importance of the presentation and expected outcome.

Community Engagement and Activity

Various strategizes employed for the success of the presentation included:

Inter-professional collaboration:

Inviting local dieticians, and physiotherapists to take part in developing the presentation

content.

Working closely with the geriatrician to review the presentation content and take part in

the question and answer session.

 Working closely with local elderly facilities to ensure that their challenges and needs are

captured and the presentation aligns with the best and current practices.

Follow-support:

 The pharmacist provided a follow-up consultation at the pharmacy for medication

reviews and lifestyle abuse.

 The attendees were given an email in which they could use to send questions and

concerns after the presentation.

Promise of an annual public health presentation on chronic diseases which has a

possibility of expanding to all members of the community regardless of the age.

Resource sharing:

The audience was issued with a resource guide that included, names, contacts and

specializations of professionals they may consult post-presentation and obtain support

for chronic disease management.

For an effective communication of outcomes, a report summary of the presentation was shared

with all stakeholders including the pharmacy staff, elderly facilities present and the collaborating

healthcare professionals.

Barriers and Enablers

Identifying potential barriers and enablers for successful planning of the public presentation.

And implementation.

The barriers identified included:

Time constraints of the participants to attend the presentation and implement the

anticipated changes.

 Resistance to change as people reluctantly accept change especially the older adults who

may not want to embrace new ways of living.

 Diverse literacy level of carers and healthcare providers.

Limited resources in reaching the aggregate population and the possibility of a

continuous annual public presentation for a better, healthier community.

Potential language barrier especially on the elderly who may have low literacy level.

Lack of corporation from elderly facilities’ management, carers and healthcare providers.

Enablers

Corporation and support from healthcare providers, and elderly facilities’ management.

 Growth in emphasis on person-centered care among the aged population.

Wide availability of evidence based practices on chronic disease risks reduction through

lifestyle change.

Increased awareness for necessity of lifestyle change among the elderly.

Expertise of pharmacists in medication review and management in health promotion.

Identifying the above barriers and enablers made the team maximize on its strengths and

minimize on their weaknesses hence a successful presentation.

Evaluation Phase

To evaluate the effectiveness of the presentation and its impact on chronic disease management

in elderly facilities an assessment plan was established. The plan involved process and outcome

evaluations.

Process Evaluation

Involved attendance recording and presentation delivery. The presentation had to adhere to the

developed content and timeframe, the technical aspects such as the audiovisuals equipment

functioning and presenter’s communication effectives were evaluated. Participant engagement

was also assessed through discussions and questions and answers as well as request for resources

by the audience.

Outcome evaluation

The outcome evaluation was carried out a survey that focused on

Knowledge gain in pre- and post-presentation evaluation.

 Change in attitude in post presentation.

And intent to change lifestyle prior and after the presentation.

Audience satisfaction following the shared information.

Meeting Objective

A total of 30 handouts, and 30 forms were printed and issued to the participants during the

presentation. Prior to the presentation, 50 posters and 20 flyers were printed and distributed

within the store, across different elderly facilities, and healthcare centers. 23 of the participants

consented on changing lifestyle in terms of having balanced diet and engaging in physical

activities regularly. 4 participants began looking for help to refrain from alcohol and substance

abuse and were given assistance in the right professionals to contact. 6 carers from various

elderly facilities did a follow-up consultation on how to better help their clients in the pharmacy

store a week after the presentation

Reflection Phase

The compaign was a success

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